- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,122.50 / $24,122.50 / $28,589.90
| Facility | | $24,122.50 | $24,122.50 | $28,589.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,886.33 / $29,102.02 / $43,534.85
| Facility | | $17,886.33 | $29,102.02 | $43,534.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,729.18 / $24,419.05 / $41,546.19
| Facility | | $19,729.18 | $24,419.05 | $41,546.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,651.37 / $28,321.67 / $46,358.49
| Facility | | $17,651.37 | $28,321.67 | $46,358.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.12 / $16,606.04 / $23,726.04
| Facility | | $263.12 | $16,606.04 | $23,726.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,086.40 / $27,980.61 / $32,884.23
| Facility | | $20,086.40 | $27,980.61 | $32,884.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,127.97 / $29,845.40 / $37,622.56
| Facility | | $18,127.97 | $29,845.40 | $37,622.56 |