- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $24,547.09 / $29,512.09
| Facility | | $20,417.38 | $24,547.09 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $22,387.21 / $35,481.34
| Facility | | $21,877.62 | $22,387.21 | $35,481.34 |
- 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
- $19,498.45 / $25,118.86 / $39,810.72
| Facility | | $19,498.45 | $25,118.86 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $33,113.11 / $33,113.11
| Facility | | $16,982.44 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $28,183.83 / $41,686.94
| Facility | | $20,417.38 | $28,183.83 | $41,686.94 |