- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,483.20 / $19,483.20 / $23,091.50
| Facility | | $19,483.20 | $19,483.20 | $23,091.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,540.95 / $23,658.91 / $35,392.29
| Facility | | $14,540.95 | $23,658.91 | $35,392.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,934.88 / $19,722.79 / $33,556.04
| Facility | | $15,934.88 | $19,722.79 | $33,556.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,256.67 / $22,874.85 / $37,442.83
| Facility | | $14,256.67 | $22,874.85 | $37,442.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.90 / $13,500.12 / $19,288.43
| Facility | | $213.90 | $13,500.12 | $19,288.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,223.39 / $22,599.38 / $26,559.94
| Facility | | $16,223.39 | $22,599.38 | $26,559.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,641.60 / $24,105.54 / $30,387.00
| Facility | | $14,641.60 | $24,105.54 | $30,387.00 |