- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,050.30 / $24,050.30 / $28,504.30
| Facility | | $24,050.30 | $24,050.30 | $28,504.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,045.43 / $29,360.88 / $43,922.08
| Facility | | $18,045.43 | $29,360.88 | $43,922.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,670.16 / $24,345.98 / $41,421.87
| Facility | | $19,670.16 | $24,345.98 | $41,421.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,598.55 / $28,236.92 / $46,219.77
| Facility | | $17,598.55 | $28,236.92 | $46,219.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.45 / $16,753.75 / $23,937.08
| Facility | | $265.45 | $16,753.75 | $23,937.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,026.29 / $27,896.88 / $32,785.83
| Facility | | $20,026.29 | $27,896.88 | $32,785.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,073.72 / $29,756.10 / $37,509.98
| Facility | | $18,073.72 | $29,756.10 | $37,509.98 |