- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,208.10 / $22,208.10 / $26,321.00
| Facility | | $22,208.10 | $22,208.10 | $26,321.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,017.50 / $26,061.32 / $38,986.15
| Facility | | $16,017.50 | $26,061.32 | $38,986.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,163.50 / $22,481.18 / $38,249.12
| Facility | | $18,163.50 | $22,481.18 | $38,249.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,250.57 / $26,074.09 / $42,679.52
| Facility | | $16,250.57 | $26,074.09 | $42,679.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.62 / $14,870.98 / $21,778.37
| Facility | | $235.62 | $14,870.98 | $21,778.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,492.36 / $25,760.09 / $30,274.56
| Facility | | $18,492.36 | $25,760.09 | $30,274.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,689.34 / $27,476.90 / $34,636.87
| Facility | | $16,689.34 | $27,476.90 | $34,636.87 |