- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,465.30 / $22,465.30 / $26,625.80
| Facility | | $22,465.30 | $22,465.30 | $26,625.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,617.58 / $25,410.63 / $38,012.76
| Facility | | $15,617.58 | $25,410.63 | $38,012.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,373.82 / $22,741.49 / $38,692.01
| Facility | | $18,373.82 | $22,741.49 | $38,692.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,438.74 / $26,376.00 / $43,173.71
| Facility | | $16,438.74 | $26,376.00 | $43,173.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.74 / $14,499.68 / $22,030.54
| Facility | | $229.74 | $14,499.68 | $22,030.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,706.48 / $26,058.37 / $30,625.11
| Facility | | $18,706.48 | $26,058.37 | $30,625.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,882.59 / $27,795.06 / $35,037.93
| Facility | | $16,882.59 | $27,795.06 | $35,037.93 |