- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,970.60 / $24,970.60 / $29,595.10
| Facility | | $24,970.60 | $24,970.60 | $29,595.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,116.25 / $29,476.12 / $44,094.48
| Facility | | $18,116.25 | $29,476.12 | $44,094.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,422.87 / $25,277.63 / $43,006.95
| Facility | | $20,422.87 | $25,277.63 | $43,006.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,271.99 / $29,317.46 / $47,988.45
| Facility | | $18,271.99 | $29,317.46 | $47,988.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.50 / $16,819.50 / $24,487.39
| Facility | | $266.50 | $16,819.50 | $24,487.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,792.63 / $28,964.40 / $34,040.43
| Facility | | $20,792.63 | $28,964.40 | $34,040.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,765.34 / $31,468.14 / $41,426.15
| Facility | | $18,765.34 | $31,468.14 | $41,426.15 |