- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,271.30 / $22,271.30 / $26,395.90
| Facility | | $22,271.30 | $22,271.30 | $26,395.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,366.20 / $26,628.68 / $39,834.89
| Facility | | $16,366.20 | $26,628.68 | $39,834.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,215.16 / $22,545.11 / $38,357.90
| Facility | | $18,215.16 | $22,545.11 | $38,357.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,296.79 / $26,148.24 / $42,800.90
| Facility | | $16,296.79 | $26,148.24 | $42,800.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.75 / $15,194.72 / $21,840.31
| Facility | | $240.75 | $15,194.72 | $21,840.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,544.95 / $25,833.35 / $30,360.66
| Facility | | $18,544.95 | $25,833.35 | $30,360.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,736.81 / $27,555.04 / $34,735.37
| Facility | | $16,736.81 | $27,555.04 | $34,735.37 |