- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,120.90 / $22,120.90 / $26,217.60
| Facility | | $22,120.90 | $22,120.90 | $26,217.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,466.11 / $25,164.18 / $37,644.08
| Facility | | $15,466.11 | $25,164.18 | $37,644.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,092.16 / $22,392.89 / $38,098.90
| Facility | | $18,092.16 | $22,392.89 | $38,098.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,186.75 / $25,971.68 / $42,511.90
| Facility | | $16,186.75 | $25,971.68 | $42,511.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.51 / $14,359.06 / $21,692.84
| Facility | | $227.51 | $14,359.06 | $21,692.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,419.73 / $25,658.92 / $30,155.66
| Facility | | $18,419.73 | $25,658.92 | $30,155.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,623.80 / $27,368.98 / $34,500.83
| Facility | | $16,623.80 | $27,368.98 | $34,500.83 |