- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $26,915.35 / $28,183.83
| Facility | | $22,908.68 | $26,915.35 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $28,840.32 / $41,686.94
| Facility | | $16,595.87 | $28,840.32 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $23,442.29 / $38,904.51
| Facility | | $19,498.45 | $23,442.29 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $22,387.21 / $28,840.32
| Facility | | $19,952.62 | $22,387.21 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $26,915.35 / $38,018.94
| Facility | | $16,595.87 | $26,915.35 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $16,982.44 / $22,387.21
| Facility | | $190.55 | $16,982.44 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $30,902.95 / $32,359.37
| Facility | | $25,118.86 | $30,902.95 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $28,840.32 / $38,904.51
| Facility | | $16,982.44 | $28,840.32 | $38,904.51 |