- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,961.50 / $22,961.50 / $27,213.90
| Facility | | $22,961.50 | $22,961.50 | $27,213.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,335.69 / $26,579.04 / $39,760.62
| Facility | | $16,335.69 | $26,579.04 | $39,760.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,779.68 / $23,243.85 / $39,546.71
| Facility | | $18,779.68 | $23,243.85 | $39,546.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,801.87 / $26,958.64 / $44,127.41
| Facility | | $16,801.87 | $26,958.64 | $44,127.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.31 / $15,166.39 / $22,517.19
| Facility | | $240.31 | $15,166.39 | $22,517.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,119.70 / $26,633.99 / $31,301.62
| Facility | | $19,119.70 | $26,633.99 | $31,301.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,255.53 / $28,409.04 / $35,811.91
| Facility | | $17,255.53 | $28,409.04 | $35,811.91 |