- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,627.70 / $22,627.70 / $26,818.30
| Facility | | $22,627.70 | $22,627.70 | $26,818.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,222.36 / $26,394.65 / $39,484.79
| Facility | | $16,222.36 | $26,394.65 | $39,484.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,506.65 / $22,905.90 / $38,971.73
| Facility | | $18,506.65 | $22,905.90 | $38,971.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,557.58 / $26,566.68 / $43,485.83
| Facility | | $16,557.58 | $26,566.68 | $43,485.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.64 / $15,061.18 / $22,189.81
| Facility | | $238.64 | $15,061.18 | $22,189.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,841.72 / $26,246.75 / $30,846.52
| Facility | | $18,841.72 | $26,246.75 | $30,846.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,004.64 / $27,996.00 / $35,291.23
| Facility | | $17,004.64 | $27,996.00 | $35,291.23 |