- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,065.30 / $24,065.30 / $28,522.10
| Facility | | $24,065.30 | $24,065.30 | $28,522.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,402.50 / $28,314.81 / $42,357.23
| Facility | | $17,402.50 | $28,314.81 | $42,357.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,682.46 / $24,361.21 / $41,447.76
| Facility | | $19,682.46 | $24,361.21 | $41,447.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,609.56 / $28,971.83 / $46,248.67
| Facility | | $17,609.56 | $28,971.83 | $46,248.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.00 / $16,156.85 / $23,599.62
| Facility | | $256.00 | $16,156.85 | $23,599.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,038.81 / $27,914.32 / $32,806.33
| Facility | | $20,038.81 | $27,914.32 | $32,806.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,085.02 / $29,774.70 / $39,924.28
| Facility | | $18,085.02 | $29,774.70 | $39,924.28 |