- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,981.20 / $25,981.20 / $30,792.80
| Facility | | $25,981.20 | $25,981.20 | $30,792.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,152.56 / $31,162.24 / $46,616.82
| Facility | | $19,152.56 | $31,162.24 | $46,616.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,249.38 / $26,300.60 / $44,747.43
| Facility | | $21,249.38 | $26,300.60 | $44,747.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,011.46 / $30,503.93 / $49,930.53
| Facility | | $19,011.46 | $30,503.93 | $49,930.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.74 / $17,781.64 / $25,478.39
| Facility | | $281.74 | $17,781.64 | $25,478.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,634.10 / $30,136.58 / $35,418.04
| Facility | | $21,634.10 | $30,136.58 | $35,418.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,524.77 / $32,145.07 / $40,521.48
| Facility | | $19,524.77 | $32,145.07 | $40,521.48 |