- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,548.00 / $22,548.00 / $26,723.80
| Facility | | $22,548.00 | $22,548.00 | $26,723.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,446.84 / $26,759.88 / $40,031.16
| Facility | | $16,446.84 | $26,759.88 | $40,031.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,441.47 / $22,825.22 / $38,834.46
| Facility | | $18,441.47 | $22,825.22 | $38,834.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,499.25 / $26,473.11 / $43,332.66
| Facility | | $16,499.25 | $26,473.11 | $43,332.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.94 / $15,269.59 / $22,111.65
| Facility | | $241.94 | $15,269.59 | $22,111.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,775.34 / $26,154.30 / $30,737.86
| Facility | | $18,775.34 | $26,154.30 | $30,737.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,944.75 / $27,897.39 / $35,166.93
| Facility | | $16,944.75 | $27,897.39 | $35,166.93 |