- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,233.59 / $20,233.59 / $23,980.80
| Facility | | $20,233.59 | $20,233.59 | $23,980.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,227.86 / $21,522.44 / $32,196.26
| Facility | | $13,227.86 | $21,522.44 | $32,196.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,548.61 / $20,482.41 / $34,848.44
| Facility | | $16,548.61 | $20,482.41 | $34,848.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,805.76 / $23,755.88 / $38,884.94
| Facility | | $14,805.76 | $23,755.88 | $38,884.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.59 / $12,281.03 / $19,458.82
| Facility | | $194.59 | $12,281.03 | $19,458.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,848.23 / $23,469.80 / $27,582.90
| Facility | | $16,848.23 | $23,469.80 | $27,582.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,205.52 / $25,033.97 / $31,557.36
| Facility | | $15,205.52 | $25,033.97 | $31,557.36 |