- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $25,118.86 / $30,199.52
| Facility | | $20,892.96 | $25,118.86 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $22,908.68 / $36,307.81
| Facility | | $22,387.21 | $22,908.68 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $25,703.96 / $40,738.03
| Facility | | $19,952.62 | $25,703.96 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $32,359.37 / $32,359.37
| Facility | | $16,218.10 | $32,359.37 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $28,840.32 / $43,651.58
| Facility | | $20,892.96 | $28,840.32 | $43,651.58 |