- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,373.50 / $21,373.50 / $25,331.80
| Facility | | $21,373.50 | $21,373.50 | $25,331.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,009.87 / $26,048.91 / $38,967.58
| Facility | | $16,009.87 | $26,048.91 | $38,967.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,480.90 / $21,636.31 / $36,811.67
| Facility | | $17,480.90 | $21,636.31 | $36,811.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,639.86 / $25,094.19 / $41,075.57
| Facility | | $15,639.86 | $25,094.19 | $41,075.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.51 / $14,863.90 / $21,236.93
| Facility | | $235.51 | $14,863.90 | $21,236.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,797.39 / $24,791.99 / $29,136.81
| Facility | | $17,797.39 | $24,791.99 | $29,136.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,062.14 / $26,444.28 / $33,335.17
| Facility | | $16,062.14 | $26,444.28 | $33,335.17 |