- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $26,302.68 / $53,703.18
| Facility | | $22,387.21 | $26,302.68 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $22,908.68 / $34,673.69
| Facility | | $14,125.38 | $22,908.68 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $19,498.45 / $30,199.52
| Facility | | $16,595.87 | $19,498.45 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $15,488.17 / $20,417.38
| Facility | | $12,882.50 | $15,488.17 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $22,387.21 / $34,673.69
| Facility | | $16,218.10 | $22,387.21 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $18,620.87 / $24,547.09
| Facility | | $13,182.57 | $18,620.87 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $21,379.62 / $26,302.68
| Facility | | $16,595.87 | $21,379.62 | $26,302.68 |