- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $26,915.35 / $53,703.18
| Facility | | $22,908.68 | $26,915.35 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $23,442.29 / $37,153.52
| Facility | | $14,454.40 | $23,442.29 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $20,417.38 / $30,199.52
| Facility | | $16,982.44 | $20,417.38 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $16,982.44 / $22,387.21
| Facility | | $13,803.84 | $16,982.44 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $22,908.68 / $36,307.81
| Facility | | $18,197.01 | $22,908.68 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $19,498.45 / $24,547.09
| Facility | | $14,125.38 | $19,498.45 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $21,877.62 / $26,302.68
| Facility | | $16,595.87 | $21,877.62 | $26,302.68 |