- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $16,982.44 / $17,782.79
| Facility | | $14,454.40 | $16,982.44 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $17,378.01 / $26,302.68
| Facility | | $7,413.10 | $17,378.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $12,589.25 / $15,135.61
| Facility | | $11,220.18 | $12,589.25 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $14,454.40 / $18,197.01
| Facility | | $12,589.25 | $14,454.40 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $16,982.44 / $27,542.29
| Facility | | $10,471.29 | $16,982.44 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $6,760.83
| Facility | | $6,760.83 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $10,964.78 / $14,454.40
| Facility | | $120.23 | $10,964.78 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $19,952.62 / $20,417.38
| Facility | | $15,848.93 | $19,952.62 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $18,197.01 / $24,547.09
| Facility | | $10,471.29 | $18,197.01 | $24,547.09 |