- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,084.80 / $20,084.80 / $23,804.40
| Facility | | $20,084.80 | $20,084.80 | $23,804.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,471.21 / $23,545.44 / $35,222.54
| Facility | | $14,471.21 | $23,545.44 | $35,222.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,426.84 / $20,331.71 / $34,592.04
| Facility | | $16,426.84 | $20,331.71 | $34,592.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,696.82 / $23,581.09 / $38,598.83
| Facility | | $14,696.82 | $23,581.09 | $38,598.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.88 / $13,435.38 / $19,696.09
| Facility | | $212.88 | $13,435.38 | $19,696.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,724.25 / $23,297.11 / $27,379.95
| Facility | | $16,724.25 | $23,297.11 | $27,379.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,093.64 / $24,849.77 / $31,325.16
| Facility | | $15,093.64 | $24,849.77 | $31,325.16 |