- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $21,877.62 / $22,908.68
| Facility | | $18,620.87 | $21,877.62 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $23,988.33 / $33,884.42
| Facility | | $13,803.84 | $23,988.33 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,498.45 / $34,673.69
| Facility | | $14,454.40 | $19,498.45 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $18,620.87 / $23,442.29
| Facility | | $16,218.10 | $18,620.87 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $21,877.62 / $35,481.34
| Facility | | $13,803.84 | $21,877.62 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $14,125.38 / $18,620.87
| Facility | | $158.49 | $14,125.38 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $25,703.96 / $26,302.68
| Facility | | $20,417.38 | $25,703.96 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $23,442.29 / $31,622.78
| Facility | | $14,125.38 | $23,442.29 | $31,622.78 |