- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,006.60 / $23,006.60 / $27,267.40
| Facility | | $23,006.60 | $23,006.60 | $27,267.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,296.80 / $28,142.82 / $42,099.95
| Facility | | $17,296.80 | $28,142.82 | $42,099.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,816.59 / $23,289.51 / $39,624.41
| Facility | | $18,816.59 | $23,289.51 | $39,624.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,834.88 / $27,011.61 / $44,214.11
| Facility | | $16,834.88 | $27,011.61 | $44,214.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.44 / $16,058.71 / $22,944.04
| Facility | | $254.44 | $16,058.71 | $22,944.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,157.27 / $26,686.32 / $31,363.12
| Facility | | $19,157.27 | $26,686.32 | $31,363.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,289.43 / $28,464.86 / $35,882.26
| Facility | | $17,289.43 | $28,464.86 | $35,882.26 |