- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,501.30 / $20,501.30 / $24,298.10
| Facility | | $20,501.30 | $20,501.30 | $24,298.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,931.06 / $24,293.64 / $36,341.81
| Facility | | $14,931.06 | $24,293.64 | $36,341.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,767.54 / $20,753.38 / $35,309.47
| Facility | | $16,767.54 | $20,753.38 | $35,309.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,001.63 / $24,070.15 / $39,399.37
| Facility | | $15,001.63 | $24,070.15 | $39,399.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.64 / $13,862.31 / $20,104.59
| Facility | | $219.64 | $13,862.31 | $20,104.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,071.12 / $23,780.29 / $27,947.80
| Facility | | $17,071.12 | $23,780.29 | $27,947.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,406.68 / $25,365.15 / $31,974.84
| Facility | | $15,406.68 | $25,365.15 | $31,974.84 |