- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,765.90 / $19,765.90 / $23,426.60
| Facility | | $19,765.90 | $19,765.90 | $23,426.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,358.97 / $23,362.82 / $34,949.35
| Facility | | $14,358.97 | $23,362.82 | $34,949.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,166.11 / $20,008.98 / $34,042.96
| Facility | | $16,166.11 | $20,008.98 | $34,042.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,463.54 / $23,206.78 / $37,986.16
| Facility | | $14,463.54 | $23,206.78 | $37,986.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.23 / $13,331.17 / $19,383.46
| Facility | | $211.23 | $13,331.17 | $19,383.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,458.80 / $22,927.32 / $26,945.34
| Facility | | $16,458.80 | $22,927.32 | $26,945.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,854.06 / $24,455.33 / $30,827.94
| Facility | | $14,854.06 | $24,455.33 | $30,827.94 |