- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $15,135.61 / $18,197.01
| Facility | | $12,589.25 | $15,135.61 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $13,489.63 / $21,877.62
| Facility | | $13,182.57 | $13,489.63 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $15,488.17 / $23,988.33
| Facility | | $12,022.64 | $15,488.17 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $21,379.62 / $21,379.62
| Facility | | $10,715.19 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $17,378.01 / $25,703.96
| Facility | | $12,302.69 | $17,378.01 | $25,703.96 |