- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,474.30 / $22,474.30 / $26,636.50
| Facility | | $22,474.30 | $22,474.30 | $26,636.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,027.65 / $27,704.89 / $41,444.83
| Facility | | $17,027.65 | $27,704.89 | $41,444.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,381.20 / $22,750.62 / $38,707.55
| Facility | | $18,381.20 | $22,750.62 | $38,707.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,445.34 / $26,566.23 / $44,033.95
| Facility | | $16,445.34 | $26,566.23 | $44,033.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.48 / $15,808.82 / $22,587.01
| Facility | | $250.48 | $15,808.82 | $22,587.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,713.99 / $26,068.83 / $30,637.41
| Facility | | $18,713.99 | $26,068.83 | $30,637.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,889.37 / $27,977.04 / $37,284.79
| Facility | | $16,889.37 | $27,977.04 | $37,284.79 |