- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $27,542.29 / $28,840.32
| Facility | | $23,442.29 | $27,542.29 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $29,512.09 / $42,657.95
| Facility | | $16,982.44 | $29,512.09 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $24,547.09 / $43,651.58
| Facility | | $17,782.79 | $24,547.09 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $23,442.29 / $29,512.09
| Facility | | $20,417.38 | $23,442.29 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $27,542.29 / $44,668.36
| Facility | | $16,982.44 | $27,542.29 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $17,782.79 / $22,908.68
| Facility | | $194.98 | $17,782.79 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $31,622.78 / $33,113.11
| Facility | | $25,703.96 | $31,622.78 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $29,512.09 / $39,810.72
| Facility | | $17,378.01 | $29,512.09 | $39,810.72 |