- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,925.40 / $22,925.40 / $27,171.20
| Facility | | $22,925.40 | $22,925.40 | $27,171.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,394.53 / $26,674.78 / $39,903.85
| Facility | | $16,394.53 | $26,674.78 | $39,903.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,750.18 / $23,207.31 / $39,484.55
| Facility | | $18,750.18 | $23,207.31 | $39,484.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,775.46 / $26,916.27 / $44,058.05
| Facility | | $16,775.46 | $26,916.27 | $44,058.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.17 / $15,221.03 / $22,481.80
| Facility | | $241.17 | $15,221.03 | $22,481.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,089.65 / $26,592.13 / $31,252.42
| Facility | | $19,089.65 | $26,592.13 | $31,252.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,228.40 / $28,364.39 / $35,755.62
| Facility | | $17,228.40 | $28,364.39 | $35,755.62 |