- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,487.90 / $23,487.90 / $27,837.70
| Facility | | $23,487.90 | $23,487.90 | $27,837.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,853.64 / $29,048.83 / $43,455.28
| Facility | | $17,853.64 | $29,048.83 | $43,455.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,210.16 / $23,776.65 / $40,453.21
| Facility | | $19,210.16 | $23,776.65 | $40,453.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,187.00 / $27,576.59 / $45,138.91
| Facility | | $17,187.00 | $27,576.59 | $45,138.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.64 / $16,575.68 / $23,682.68
| Facility | | $262.64 | $16,575.68 | $23,682.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,557.97 / $27,244.50 / $32,019.12
| Facility | | $19,557.97 | $27,244.50 | $32,019.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,651.06 / $29,060.24 / $36,632.80
| Facility | | $17,651.06 | $29,060.24 | $36,632.80 |