- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,297.60 / $18,427.70 / $37,449.90
| Facility | | $14,297.60 | $18,427.70 | $37,449.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,327.24 / $20,391.25 / $25,139.28
| Facility | | $15,327.24 | $20,391.25 | $25,139.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,229.11 / $17,836.49 / $20,391.72
| Facility | | $14,229.11 | $17,836.49 | $20,391.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,412.54 / $20,201.40 / $26,272.79
| Facility | | $11,412.54 | $20,201.40 | $26,272.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,626.33 / $17,626.33 / $17,626.33
| Facility | | $17,626.33 | $17,626.33 | $17,626.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $18,355.84 / $25,805.92
| Facility | | $1,518.00 | $18,355.84 | $25,805.92 |