- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $23,442.29 / $26,915.35
| Facility | | $18,197.01 | $23,442.29 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $20,892.96 / $24,547.09
| Facility | | $20,892.96 | $20,892.96 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $19,952.62 / $23,988.33
| Facility | | $16,982.44 | $19,952.62 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $26,915.35 / $33,113.11
| Facility | | $16,595.87 | $26,915.35 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $28,183.83
| Facility | | $23,988.33 | $23,988.33 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $26,302.68 / $34,673.69
| Facility | | $1,862.09 | $26,302.68 | $34,673.69 |