- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $26,915.35 / $32,359.37
| Facility | | $22,387.21 | $26,915.35 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $24,547.09 / $38,904.51
| Facility | | $23,988.33 | $24,547.09 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $27,542.29 / $43,651.58
| Facility | | $21,379.62 | $27,542.29 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $34,673.69 / $34,673.69
| Facility | | $16,982.44 | $34,673.69 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $30,902.95 / $45,708.82
| Facility | | $22,387.21 | $30,902.95 | $45,708.82 |