- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $24,547.09 / $29,512.09
| Facility | | $19,952.62 | $24,547.09 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,877.62 / $35,481.34
| Facility | | $21,379.62 | $21,877.62 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $24,547.09 / $38,904.51
| Facility | | $19,054.61 | $24,547.09 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $31,622.78 / $31,622.78
| Facility | | $15,848.93 | $31,622.78 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $27,542.29 / $41,686.94
| Facility | | $19,952.62 | $27,542.29 | $41,686.94 |