- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,426.10 / $21,426.10 / $25,394.20
| Facility | | $21,426.10 | $21,426.10 | $25,394.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,947.75 / $25,947.85 / $38,816.41
| Facility | | $15,947.75 | $25,947.85 | $38,816.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,523.93 / $21,689.59 / $36,902.32
| Facility | | $17,523.93 | $21,689.59 | $36,902.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,678.37 / $25,155.98 / $41,176.72
| Facility | | $15,678.37 | $25,155.98 | $41,176.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.60 / $14,806.23 / $21,154.54
| Facility | | $234.60 | $14,806.23 | $21,154.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,841.22 / $24,853.04 / $29,208.56
| Facility | | $17,841.22 | $24,853.04 | $29,208.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,101.69 / $26,509.40 / $33,417.26
| Facility | | $16,101.69 | $26,509.40 | $33,417.26 |