- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,071.20 / $21,071.20 / $24,973.60
| Facility | | $21,071.20 | $21,071.20 | $24,973.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,360.75 / $26,619.82 / $39,821.62
| Facility | | $16,360.75 | $26,619.82 | $39,821.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,233.68 / $21,330.33 / $36,291.08
| Facility | | $17,233.68 | $21,330.33 | $36,291.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,418.68 / $24,739.31 / $40,494.68
| Facility | | $15,418.68 | $24,739.31 | $40,494.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.67 / $15,189.66 / $21,702.38
| Facility | | $240.67 | $15,189.66 | $21,702.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,545.70 / $24,441.38 / $28,724.75
| Facility | | $17,545.70 | $24,441.38 | $28,724.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,708.40 / $25,877.36 / $32,863.74
| Facility | | $14,708.40 | $25,877.36 | $32,863.74 |