- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,436.70 / $23,436.70 / $27,777.10
| Facility | | $23,436.70 | $23,436.70 | $27,777.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,217.25 / $28,013.40 / $41,906.33
| Facility | | $17,217.25 | $28,013.40 | $41,906.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,168.34 / $23,724.89 / $40,365.15
| Facility | | $19,168.34 | $23,724.89 | $40,365.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,149.59 / $27,516.56 / $45,040.65
| Facility | | $17,149.59 | $27,516.56 | $45,040.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.27 / $15,984.86 / $22,983.20
| Facility | | $253.27 | $15,984.86 | $22,983.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,515.40 / $27,185.20 / $31,949.42
| Facility | | $19,515.40 | $27,185.20 | $31,949.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,612.64 / $28,996.98 / $36,553.06
| Facility | | $17,612.64 | $28,996.98 | $36,553.06 |