- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,960.10 / $26,960.10 / $31,953.10
| Facility | | $26,960.10 | $26,960.10 | $31,953.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,124.23 / $31,116.15 / $46,547.86
| Facility | | $19,124.23 | $31,116.15 | $46,547.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,050.06 / $27,291.62 / $46,433.52
| Facility | | $22,050.06 | $27,291.62 | $46,433.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,727.81 / $31,653.32 / $51,811.92
| Facility | | $19,727.81 | $31,653.32 | $51,811.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.33 / $17,755.34 / $26,438.42
| Facility | | $281.33 | $17,755.34 | $26,438.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,449.28 / $31,272.13 / $36,752.60
| Facility | | $22,449.28 | $31,272.13 | $36,752.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,260.47 / $33,356.30 / $42,048.33
| Facility | | $20,260.47 | $33,356.30 | $42,048.33 |