- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,701.30 / $21,701.30 / $25,720.40
| Facility | | $21,701.30 | $21,701.30 | $25,720.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,682.96 / $25,517.01 / $38,171.90
| Facility | | $15,682.96 | $25,517.01 | $38,171.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,749.02 / $21,968.17 / $37,376.29
| Facility | | $17,749.02 | $21,968.17 | $37,376.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,879.74 / $25,479.08 / $41,705.58
| Facility | | $15,879.74 | $25,479.08 | $41,705.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.70 / $14,560.39 / $21,281.40
| Facility | | $230.70 | $14,560.39 | $21,281.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,070.37 / $25,172.25 / $29,583.71
| Facility | | $18,070.37 | $25,172.25 | $29,583.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,308.50 / $26,849.89 / $33,846.47
| Facility | | $16,308.50 | $26,849.89 | $33,846.47 |