- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,875.80 / $23,875.80 / $28,297.60
| Facility | | $23,875.80 | $23,875.80 | $28,297.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,902.33 / $27,501.00 / $41,139.82
| Facility | | $16,902.33 | $27,501.00 | $41,139.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,527.49 / $24,169.40 / $41,121.43
| Facility | | $19,527.49 | $24,169.40 | $41,121.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,470.91 / $28,032.11 / $45,884.53
| Facility | | $17,470.91 | $28,032.11 | $45,884.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.64 / $15,692.48 / $23,413.81
| Facility | | $248.64 | $15,692.48 | $23,413.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,881.04 / $27,694.54 / $32,548.02
| Facility | | $19,881.04 | $27,694.54 | $32,548.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,942.63 / $29,540.27 / $37,237.92
| Facility | | $17,942.63 | $29,540.27 | $37,237.92 |