- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $26,302.68 / $26,915.35
| Facility | | $21,877.62 | $26,302.68 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $28,183.83 / $40,738.03
| Facility | | $16,218.10 | $28,183.83 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $22,908.68 / $41,686.94
| Facility | | $16,982.44 | $22,908.68 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $21,877.62 / $28,183.83
| Facility | | $19,054.61 | $21,877.62 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $25,703.96 / $42,657.95
| Facility | | $16,218.10 | $25,703.96 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $16,595.87 / $21,877.62
| Facility | | $186.21 | $16,595.87 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $30,199.52 / $31,622.78
| Facility | | $23,988.33 | $30,199.52 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $27,542.29 / $38,018.94
| Facility | | $16,218.10 | $27,542.29 | $38,018.94 |