- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $26,915.35 / $53,703.18
| Facility | | $22,908.68 | $26,915.35 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $23,442.29 / $36,307.81
| Facility | | $14,454.40 | $23,442.29 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $21,379.62 / $30,902.95
| Facility | | $17,378.01 | $21,379.62 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $20,417.38 / $26,302.68
| Facility | | $14,454.40 | $20,417.38 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $23,442.29 / $35,481.34
| Facility | | $18,197.01 | $23,442.29 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $19,498.45 / $26,302.68
| Facility | | $15,135.61 | $19,498.45 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $21,877.62 / $26,302.68
| Facility | | $16,595.87 | $21,877.62 | $26,302.68 |