- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,164.60 / $27,164.60 / $32,195.50
| Facility | | $27,164.60 | $27,164.60 | $32,195.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,120.56 / $34,364.28 / $51,406.87
| Facility | | $21,120.56 | $34,364.28 | $51,406.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,217.33 / $27,498.65 / $46,785.76
| Facility | | $22,217.33 | $27,498.65 | $46,785.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,877.46 / $31,893.44 / $52,204.96
| Facility | | $19,877.46 | $31,893.44 | $52,204.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.69 / $19,608.77 / $28,016.22
| Facility | | $310.69 | $19,608.77 | $28,016.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,619.58 / $31,509.36 / $37,031.40
| Facility | | $22,619.58 | $31,509.36 | $37,031.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,414.16 / $33,609.33 / $42,367.31
| Facility | | $20,414.16 | $33,609.33 | $42,367.31 |