- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,081.80 / $23,081.80 / $27,356.50
| Facility | | $23,081.80 | $23,081.80 | $27,356.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,683.30 / $27,144.63 / $40,606.71
| Facility | | $16,683.30 | $27,144.63 | $40,606.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,878.09 / $23,365.63 / $39,753.91
| Facility | | $18,878.09 | $23,365.63 | $39,753.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,889.90 / $27,099.89 / $44,358.61
| Facility | | $16,889.90 | $27,099.89 | $44,358.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.42 / $15,489.13 / $22,635.17
| Facility | | $245.42 | $15,489.13 | $22,635.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,219.88 / $26,773.54 / $31,465.62
| Facility | | $19,219.88 | $26,773.54 | $31,465.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,345.93 / $28,557.89 / $35,999.54
| Facility | | $17,345.93 | $28,557.89 | $35,999.54 |