- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,862.20 / $20,862.20 / $24,725.80
| Facility | | $20,862.20 | $20,862.20 | $24,725.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,844.98 / $24,153.57 / $36,132.28
| Facility | | $14,844.98 | $24,153.57 | $36,132.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,062.72 / $21,118.73 / $35,931.07
| Facility | | $17,062.72 | $21,118.73 | $35,931.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,265.72 / $24,493.89 / $40,092.97
| Facility | | $15,265.72 | $24,493.89 | $40,092.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.38 / $13,782.39 / $20,458.50
| Facility | | $218.38 | $13,782.39 | $20,458.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,371.65 / $24,198.92 / $28,439.80
| Facility | | $17,371.65 | $24,198.92 | $28,439.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,677.91 / $25,811.69 / $32,537.73
| Facility | | $15,677.91 | $25,811.69 | $32,537.73 |