- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,487.80 / $20,487.80 / $24,282.10
| Facility | | $20,487.80 | $20,487.80 | $24,282.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,182.79 / $24,703.20 / $36,954.49
| Facility | | $15,182.79 | $24,703.20 | $36,954.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,756.47 / $20,739.68 / $35,286.16
| Facility | | $16,756.47 | $20,739.68 | $35,286.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,991.73 / $24,054.26 / $39,373.36
| Facility | | $14,991.73 | $24,054.26 | $39,373.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.35 / $14,096.02 / $20,139.82
| Facility | | $223.35 | $14,096.02 | $20,139.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,059.84 / $23,764.59 / $27,929.35
| Facility | | $17,059.84 | $23,764.59 | $27,929.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,396.51 / $25,348.41 / $31,953.73
| Facility | | $15,396.51 | $25,348.41 | $31,953.73 |