- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,860.80 / $22,860.80 / $27,094.50
| Facility | | $22,860.80 | $22,860.80 | $27,094.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,644.07 / $27,080.80 / $40,511.23
| Facility | | $16,644.07 | $27,080.80 | $40,511.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,697.29 / $23,141.85 / $39,373.18
| Facility | | $18,697.29 | $23,141.85 | $39,373.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,728.14 / $26,840.35 / $43,933.78
| Facility | | $16,728.14 | $26,840.35 | $43,933.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.84 / $15,452.71 / $22,418.39
| Facility | | $244.84 | $15,452.71 | $22,418.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,035.81 / $26,517.12 / $31,164.27
| Facility | | $19,035.81 | $26,517.12 | $31,164.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,179.81 / $28,284.39 / $35,654.76
| Facility | | $17,179.81 | $28,284.39 | $35,654.76 |