- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,976.70 / $26,976.70 / $31,972.70
| Facility | | $26,976.70 | $26,976.70 | $31,972.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,843.78 / $33,913.94 / $50,733.19
| Facility | | $20,843.78 | $33,913.94 | $50,733.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,063.59 / $27,308.36 / $46,462.01
| Facility | | $22,063.59 | $27,308.36 | $46,462.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,739.91 / $31,672.74 / $51,843.71
| Facility | | $19,739.91 | $31,672.74 | $51,843.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.62 / $19,351.80 / $27,649.06
| Facility | | $306.62 | $19,351.80 | $27,649.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,463.05 / $31,291.32 / $36,775.15
| Facility | | $22,463.05 | $31,291.32 | $36,775.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,272.90 / $33,996.19 / $44,754.22
| Facility | | $20,272.90 | $33,996.19 | $44,754.22 |