- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,218.59 / $20,218.59 / $23,963.00
| Facility | | $20,218.59 | $20,218.59 | $23,963.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,022.94 / $26,070.19 / $38,999.41
| Facility | | $16,022.94 | $26,070.19 | $38,999.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,536.31 / $20,467.18 / $34,822.55
| Facility | | $16,536.31 | $20,467.18 | $34,822.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,794.76 / $23,738.22 / $38,856.05
| Facility | | $14,794.76 | $23,738.22 | $38,856.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.71 / $14,876.04 / $21,254.28
| Facility | | $235.71 | $14,876.04 | $21,254.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,835.71 / $23,452.36 / $27,562.40
| Facility | | $16,835.71 | $23,452.36 | $27,562.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,194.22 / $25,015.36 / $31,533.90
| Facility | | $15,194.22 | $25,015.36 | $31,533.90 |