- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $16,595.87 / $17,378.01
| Facility | | $14,125.38 | $16,595.87 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $16,982.44 / $25,703.96
| Facility | | $7,413.10 | $16,982.44 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $12,302.69 / $14,791.08
| Facility | | $10,964.78 | $12,302.69 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $14,125.38 / $17,782.79
| Facility | | $12,302.69 | $14,125.38 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $16,595.87 / $26,915.35
| Facility | | $10,232.93 | $16,595.87 | $26,915.35 |
- 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 / $10,715.19 / $14,125.38
| Facility | | $120.23 | $10,715.19 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $19,498.45 / $19,952.62
| Facility | | $15,488.17 | $19,498.45 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $17,782.79 / $23,988.33
| Facility | | $10,232.93 | $17,782.79 | $23,988.33 |