- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,178.30 / $22,140.50 / $44,995.40
| Facility | | $17,178.30 | $22,140.50 | $44,995.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,046.24 / $24,784.86 / $26,553.92
| Facility | | $21,046.24 | $24,784.86 | $26,553.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,841.91 / $21,111.69 / $24,136.12
| Facility | | $16,841.91 | $21,111.69 | $24,136.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,711.98 / $24,271.65 / $31,566.33
| Facility | | $13,711.98 | $24,271.65 | $31,566.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,359.83 / $27,393.30 / $30,835.41
| Facility | | $24,359.83 | $27,393.30 | $30,835.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $22,054.24 / $31,005.38
| Facility | | $1,518.00 | $22,054.24 | $31,005.38 |