- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,388.40 / $15,388.40 / $18,238.30
| Facility | | $15,388.40 | $15,388.40 | $18,238.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,234.80 / $18,279.63 / $27,345.21
| Facility | | $11,234.80 | $18,279.63 | $27,345.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,585.80 / $15,577.59 / $26,503.47
| Facility | | $12,585.80 | $15,577.59 | $26,503.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,260.30 / $18,067.18 / $29,573.37
| Facility | | $11,260.30 | $18,067.18 | $29,573.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.27 / $10,430.62 / $15,090.61
| Facility | | $165.27 | $10,430.62 | $15,090.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,813.67 / $17,849.61 / $20,977.76
| Facility | | $12,813.67 | $17,849.61 | $20,977.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,256.30 / $19,392.56 / $25,529.29
| Facility | | $11,256.30 | $19,392.56 | $25,529.29 |