- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,095.40 / $24,095.40 / $28,557.80
| Facility | | $24,095.40 | $24,095.40 | $28,557.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,364.36 / $28,252.75 / $42,264.40
| Facility | | $17,364.36 | $28,252.75 | $42,264.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,707.06 / $24,391.65 / $41,499.57
| Facility | | $19,707.06 | $24,391.65 | $41,499.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,631.56 / $28,289.89 / $46,306.47
| Facility | | $17,631.56 | $28,289.89 | $46,306.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $255.44 / $16,121.44 / $23,629.12
| Facility | | $255.44 | $16,121.44 | $23,629.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,063.86 / $27,949.21 / $32,847.33
| Facility | | $20,063.86 | $27,949.21 | $32,847.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,819.34 / $29,591.28 / $37,580.33
| Facility | | $16,819.34 | $29,591.28 | $37,580.33 |