- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $28,183.83 / $29,512.09
| Facility | | $23,988.33 | $28,183.83 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $30,902.95 / $43,651.58
| Facility | | $17,782.79 | $30,902.95 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $25,118.86 / $44,668.36
| Facility | | $18,620.87 | $25,118.86 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $23,988.33 / $30,199.52
| Facility | | $20,892.96 | $23,988.33 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $28,183.83 / $45,708.82
| Facility | | $17,782.79 | $28,183.83 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $18,197.01 / $23,988.33
| Facility | | $204.17 | $18,197.01 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $33,113.11 / $33,884.42
| Facility | | $26,302.68 | $33,113.11 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $30,199.52 / $40,738.03
| Facility | | $17,782.79 | $30,199.52 | $40,738.03 |