- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,605.10 / $21,605.10 / $25,606.30
| Facility | | $21,605.10 | $21,605.10 | $25,606.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,869.30 / $25,820.19 / $38,625.44
| Facility | | $15,869.30 | $25,820.19 | $38,625.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,670.30 / $21,870.74 / $37,210.53
| Facility | | $17,670.30 | $21,870.74 | $37,210.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,809.32 / $25,366.09 / $41,520.62
| Facility | | $15,809.32 | $25,366.09 | $41,520.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $233.44 / $14,733.39 / $21,187.01
| Facility | | $233.44 | $14,733.39 | $21,187.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,990.23 / $25,060.62 / $29,452.51
| Facility | | $17,990.23 | $25,060.62 | $29,452.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,803.70 / $27,226.90 / $35,842.79
| Facility | | $15,803.70 | $27,226.90 | $35,842.79 |