- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,083.30 / $22,083.30 / $26,173.10
| Facility | | $22,083.30 | $22,083.30 | $26,173.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,529.65 / $26,894.63 / $40,232.73
| Facility | | $16,529.65 | $26,894.63 | $40,232.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,061.41 / $22,354.83 / $38,034.15
| Facility | | $18,061.41 | $22,354.83 | $38,034.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,159.24 / $25,927.54 / $42,439.65
| Facility | | $16,159.24 | $25,927.54 | $42,439.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.16 / $15,346.48 / $21,926.43
| Facility | | $243.16 | $15,346.48 | $21,926.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,388.41 / $25,615.31 / $30,104.41
| Facility | | $18,388.41 | $25,615.31 | $30,104.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.55 / $27,322.47 / $34,442.19
| Facility | | $16,595.55 | $27,322.47 | $34,442.19 |