- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,143.20 / $14,143.20 / $16,762.50
| Facility | | $14,143.20 | $14,143.20 | $16,762.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,944.60 / $16,180.39 / $24,204.88
| Facility | | $9,944.60 | $16,180.39 | $24,204.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,567.43 / $14,317.14 / $24,358.95
| Facility | | $11,567.43 | $14,317.14 | $24,358.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,349.18 / $16,605.28 / $27,180.45
| Facility | | $10,349.18 | $16,605.28 | $27,180.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.29 / $9,232.77 / $13,869.55
| Facility | | $146.29 | $9,232.77 | $13,869.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,776.86 / $16,405.31 / $19,280.34
| Facility | | $11,776.86 | $16,405.31 | $19,280.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,628.61 / $17,498.66 / $22,058.49
| Facility | | $10,628.61 | $17,498.66 | $22,058.49 |