- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,445.70 / $21,445.70 / $25,417.40
| Facility | | $21,445.70 | $21,445.70 | $25,417.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,968.11 / $24,353.92 / $36,431.99
| Facility | | $14,968.11 | $24,353.92 | $36,431.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,539.93 / $21,709.38 / $36,935.99
| Facility | | $17,539.93 | $21,709.38 | $36,935.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,692.68 / $25,178.94 / $41,214.29
| Facility | | $15,692.68 | $25,178.94 | $41,214.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.19 / $13,896.71 / $21,030.70
| Facility | | $220.19 | $13,896.71 | $21,030.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,857.50 / $24,875.72 / $29,235.21
| Facility | | $17,857.50 | $24,875.72 | $29,235.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,116.38 / $26,533.59 / $33,447.75
| Facility | | $16,116.38 | $26,533.59 | $33,447.75 |