- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,194.40 / $15,194.40 / $18,008.40
| Facility | | $15,194.40 | $15,194.40 | $18,008.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,462.55 / $18,650.18 / $27,899.54
| Facility | | $11,462.55 | $18,650.18 | $27,899.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,427.14 / $15,381.22 / $26,169.36
| Facility | | $12,427.14 | $15,381.22 | $26,169.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,118.35 / $17,839.41 / $29,200.56
| Facility | | $11,118.35 | $17,839.41 | $29,200.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.62 / $10,642.07 / $15,204.96
| Facility | | $168.62 | $10,642.07 | $15,204.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,652.14 / $17,624.59 / $20,713.31
| Facility | | $12,652.14 | $17,624.59 | $20,713.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,418.55 / $18,799.20 / $23,697.92
| Facility | | $11,418.55 | $18,799.20 | $23,697.92 |