- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,793.20 / $26,793.20 / $31,755.20
| Facility | | $26,793.20 | $26,793.20 | $31,755.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,063.21 / $31,016.86 / $46,399.33
| Facility | | $19,063.21 | $31,016.86 | $46,399.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,913.54 / $27,122.64 / $46,146.03
| Facility | | $21,913.54 | $27,122.64 | $46,146.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,605.66 / $31,457.34 / $51,491.13
| Facility | | $19,605.66 | $31,457.34 | $51,491.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.43 / $17,698.68 / $26,274.73
| Facility | | $280.43 | $17,698.68 | $26,274.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,310.29 / $31,078.51 / $36,525.05
| Facility | | $22,310.29 | $31,078.51 | $36,525.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,135.03 / $33,149.78 / $41,787.99
| Facility | | $20,135.03 | $33,149.78 | $41,787.99 |