- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,494.40 / $22,547.80 / $45,823.20
| Facility | | $17,494.40 | $22,547.80 | $45,823.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,307.52 / $21,307.52 / $21,307.52
| Facility | | $21,307.52 | $21,307.52 | $21,307.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,470.25 / $21,899.34 / $25,036.61
| Facility | | $17,470.25 | $21,899.34 | $25,036.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,964.24 / $24,718.16 / $32,147.04
| Facility | | $13,964.24 | $24,718.16 | $32,147.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,503.65 / $24,503.65 / $24,503.65
| Facility | | $24,503.65 | $24,503.65 | $24,503.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $21,446.82 / $31,575.77
| Facility | | $1,518.00 | $21,446.82 | $31,575.77 |