- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,870.10 / $20,068.70 / $30,556.70
| Facility | | $12,870.10 | $20,068.70 | $30,556.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,606.46 / $20,809.54 / $25,131.84
| Facility | | $19,606.46 | $20,809.54 | $25,131.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,779.78 / $19,616.31 / $29,010.62
| Facility | | $12,779.78 | $19,616.31 | $29,010.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,983.60 / $14,658.84 / $17,892.50
| Facility | | $11,983.60 | $14,658.84 | $17,892.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.43 / $220.16 / $1,062.00
| Facility | | $139.43 | $220.16 | $1,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,045.45 / $21,243.10 / $33,753.72
| Facility | | $15,045.45 | $21,243.10 | $33,753.72 |