- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,045.70 / $21,045.70 / $24,943.30
| Facility | | $21,045.70 | $21,045.70 | $24,943.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,012.05 / $26,052.46 / $38,972.89
| Facility | | $16,012.05 | $26,052.46 | $38,972.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,212.77 / $21,304.45 / $36,247.05
| Facility | | $17,212.77 | $21,304.45 | $36,247.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,399.97 / $24,709.29 / $40,445.55
| Facility | | $15,399.97 | $24,709.29 | $40,445.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.54 / $14,865.92 / $21,239.82
| Facility | | $235.54 | $14,865.92 | $21,239.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,524.41 / $24,411.73 / $28,689.90
| Facility | | $17,524.41 | $24,411.73 | $28,689.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,815.78 / $26,038.68 / $32,823.87
| Facility | | $15,815.78 | $26,038.68 | $32,823.87 |