- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,336.00 / $23,336.00 / $27,657.70
| Facility | | $23,336.00 | $23,336.00 | $27,657.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,389.08 / $26,665.92 / $39,890.58
| Facility | | $16,389.08 | $26,665.92 | $39,890.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,085.95 / $23,622.90 / $40,191.62
| Facility | | $19,085.95 | $23,622.90 | $40,191.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,075.87 / $27,398.27 / $44,847.02
| Facility | | $17,075.87 | $27,398.27 | $44,847.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.09 / $15,215.97 / $22,884.39
| Facility | | $241.09 | $15,215.97 | $22,884.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,431.50 / $27,068.33 / $31,812.07
| Facility | | $19,431.50 | $27,068.33 | $31,812.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,536.91 / $29,408.16 / $38,714.31
| Facility | | $17,536.91 | $29,408.16 | $38,714.31 |