- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,289.30 / $20,289.30 / $24,046.80
| Facility | | $20,289.30 | $20,289.30 | $24,046.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,335.69 / $26,579.04 / $39,760.62
| Facility | | $16,335.69 | $26,579.04 | $39,760.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,594.12 / $20,538.74 / $34,944.28
| Facility | | $16,594.12 | $20,538.74 | $34,944.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,846.48 / $23,821.21 / $38,991.87
| Facility | | $14,846.48 | $23,821.21 | $38,991.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.31 / $15,166.39 / $21,669.13
| Facility | | $240.31 | $15,166.39 | $21,669.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,894.56 / $23,534.34 / $27,658.75
| Facility | | $16,894.56 | $23,534.34 | $27,658.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,247.34 / $25,102.81 / $31,644.14
| Facility | | $15,247.34 | $25,102.81 | $31,644.14 |