- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $23,988.33 / $27,542.29
| Facility | | $18,620.87 | $23,988.33 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $19,054.61 / $19,054.61
| Facility | | $19,054.61 | $19,054.61 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $19,498.45 / $23,988.33
| Facility | | $16,595.87 | $19,498.45 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $26,915.35 / $33,884.42
| Facility | | $16,982.44 | $26,915.35 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $21,877.62 / $21,877.62
| Facility | | $21,877.62 | $21,877.62 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $25,118.86 / $32,359.37
| Facility | | $1,513.56 | $25,118.86 | $32,359.37 |