- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,694.59 / $24,379.10 / $32,042.60
| Facility | | $16,694.59 | $24,379.10 | $32,042.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,926.12 / $18,926.12 / $18,926.12
| Facility | | $18,926.12 | $18,926.12 | $18,926.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,642.74 / $28,984.21 / $49,022.88
| Facility | | $10,642.74 | $28,984.21 | $49,022.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,571.89 / $24,600.34 / $43,880.06
| Facility | | $17,571.89 | $24,600.34 | $43,880.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,999.59 / $27,328.36 / $39,901.62
| Facility | | $20,999.59 | $27,328.36 | $39,901.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,999.59 / $25,405.35 / $39,901.62
| Facility | | $20,999.59 | $25,405.35 | $39,901.62 |