- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,896.80 / $19,896.80 / $23,581.60
| Facility | | $19,896.80 | $19,896.80 | $23,581.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,208.59 / $23,118.14 / $34,583.33
| Facility | | $14,208.59 | $23,118.14 | $34,583.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,273.11 / $20,141.41 / $34,268.29
| Facility | | $16,273.11 | $20,141.41 | $34,268.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,559.27 / $23,360.39 / $38,237.58
| Facility | | $14,559.27 | $23,360.39 | $38,237.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.02 / $13,191.56 / $19,511.75
| Facility | | $209.02 | $13,191.56 | $19,511.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,567.74 / $23,079.07 / $27,123.70
| Facility | | $16,567.74 | $23,079.07 | $27,123.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,554.10 / $25,074.07 / $33,008.69
| Facility | | $14,554.10 | $25,074.07 | $33,008.69 |