- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,193.10 / $22,193.10 / $26,303.20
| Facility | | $22,193.10 | $22,193.10 | $26,303.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,051.68 / $22,862.83 / $34,201.40
| Facility | | $14,051.68 | $22,862.83 | $34,201.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,151.20 / $22,465.96 / $38,223.22
| Facility | | $18,151.20 | $22,465.96 | $38,223.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,239.57 / $26,056.43 / $42,650.62
| Facility | | $16,239.57 | $26,056.43 | $42,650.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.71 / $13,045.87 / $20,670.68
| Facility | | $206.71 | $13,045.87 | $20,670.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,479.83 / $25,742.65 / $30,254.06
| Facility | | $18,479.83 | $25,742.65 | $30,254.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,678.05 / $27,458.29 / $34,613.41
| Facility | | $16,678.05 | $27,458.29 | $34,613.41 |