- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,385.50 / $21,385.50 / $25,346.10
| Facility | | $21,385.50 | $21,385.50 | $25,346.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,524.26 / $22,004.70 / $32,917.69
| Facility | | $13,524.26 | $22,004.70 | $32,917.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,490.74 / $21,648.49 / $36,832.39
| Facility | | $17,490.74 | $21,648.49 | $36,832.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,648.66 / $25,108.31 / $41,098.69
| Facility | | $15,648.66 | $25,108.31 | $41,098.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.95 / $12,556.21 / $19,894.83
| Facility | | $198.95 | $12,556.21 | $19,894.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,807.41 / $24,805.95 / $29,153.21
| Facility | | $17,807.41 | $24,805.95 | $29,153.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,071.18 / $26,459.17 / $33,353.93
| Facility | | $16,071.18 | $26,459.17 | $33,353.93 |