- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,758.40 / $21,599.30 / $43,895.50
| Facility | | $16,758.40 | $21,599.30 | $43,895.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,005.48 / $18,005.48 / $23,235.98
| Facility | | $18,005.48 | $18,005.48 | $23,235.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,913.62 / $21,201.58 / $24,238.89
| Facility | | $16,913.62 | $21,201.58 | $24,238.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,376.79 / $23,678.33 / $30,794.68
| Facility | | $13,376.79 | $23,678.33 | $30,794.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,706.30 / $20,706.30 / $27,322.16
| Facility | | $20,706.30 | $20,706.30 | $27,322.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $21,515.12 / $30,247.45
| Facility | | $1,518.00 | $21,515.12 | $30,247.45 |