- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,006.70 / $24,006.70 / $28,452.60
| Facility | | $24,006.70 | $24,006.70 | $28,452.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,134.43 / $27,878.65 / $41,704.76
| Facility | | $17,134.43 | $27,878.65 | $41,704.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,634.49 / $24,301.84 / $41,346.76
| Facility | | $19,634.49 | $24,301.84 | $41,346.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,566.64 / $28,185.72 / $46,135.96
| Facility | | $17,566.64 | $28,185.72 | $46,135.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.06 / $15,907.97 / $23,542.11
| Facility | | $252.06 | $15,907.97 | $23,542.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,989.98 / $27,846.29 / $32,726.38
| Facility | | $19,989.98 | $27,846.29 | $32,726.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,040.95 / $29,702.14 / $37,441.97
| Facility | | $18,040.95 | $29,702.14 | $37,441.97 |