- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $25,118.86 / $26,302.68
| Facility | | $21,379.62 | $25,118.86 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $26,915.35 / $38,904.51
| Facility | | $15,488.17 | $26,915.35 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $22,387.21 / $39,810.72
| Facility | | $16,595.87 | $22,387.21 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $21,379.62 / $26,915.35
| Facility | | $18,620.87 | $21,379.62 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $25,118.86 / $40,738.03
| Facility | | $15,488.17 | $25,118.86 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $16,218.10 / $21,379.62
| Facility | | $177.83 | $16,218.10 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $29,512.09 / $30,199.52
| Facility | | $23,442.29 | $29,512.09 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $26,915.35 / $36,307.81
| Facility | | $15,488.17 | $26,915.35 | $36,307.81 |