- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,304.20 / $15,304.20 / $18,138.50
| Facility | | $15,304.20 | $15,304.20 | $18,138.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,113.85 / $18,082.82 / $27,050.80
| Facility | | $11,113.85 | $18,082.82 | $27,050.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,516.93 / $15,492.35 / $26,358.43
| Facility | | $12,516.93 | $15,492.35 | $26,358.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,198.68 / $17,968.31 / $29,411.53
| Facility | | $11,198.68 | $17,968.31 | $29,411.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.49 / $10,318.33 / $15,008.02
| Facility | | $163.49 | $10,318.33 | $15,008.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,743.55 / $17,751.91 / $20,862.96
| Facility | | $12,743.55 | $17,751.91 | $20,862.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,501.05 / $18,935.02 / $23,869.14
| Facility | | $11,501.05 | $18,935.02 | $23,869.14 |