- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,505.70 / $15,505.70 / $18,377.30
| Facility | | $15,505.70 | $15,505.70 | $18,377.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,442.93 / $18,618.27 / $27,851.80
| Facility | | $11,442.93 | $18,618.27 | $27,851.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,681.74 / $15,696.33 / $26,705.49
| Facility | | $12,681.74 | $15,696.33 | $26,705.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,346.13 / $18,204.90 / $29,798.79
| Facility | | $11,346.13 | $18,204.90 | $29,798.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.33 / $10,623.86 / $15,205.63
| Facility | | $168.33 | $10,623.86 | $15,205.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,911.34 / $17,985.66 / $21,137.66
| Facility | | $12,911.34 | $17,985.66 | $21,137.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,652.48 / $19,184.34 / $24,183.42
| Facility | | $11,652.48 | $19,184.34 | $24,183.42 |