- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,021.60 / $21,021.60 / $24,914.80
| Facility | | $21,021.60 | $21,021.60 | $24,914.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,766.52 / $24,025.92 / $35,941.31
| Facility | | $14,766.52 | $24,025.92 | $35,941.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,193.09 / $21,280.09 / $36,205.61
| Facility | | $17,193.09 | $21,280.09 | $36,205.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,382.37 / $24,681.04 / $40,399.31
| Facility | | $15,382.37 | $24,681.04 | $40,399.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.22 / $13,709.55 / $20,614.83
| Facility | | $217.22 | $13,709.55 | $20,614.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,504.38 / $24,383.82 / $28,657.10
| Facility | | $17,504.38 | $24,383.82 | $28,657.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,797.70 / $26,008.91 / $32,786.35
| Facility | | $15,797.70 | $26,008.91 | $32,786.35 |