- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,117.90 / $21,117.90 / $25,028.80
| Facility | | $21,117.90 | $21,117.90 | $25,028.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,330.98 / $24,944.33 / $37,315.19
| Facility | | $15,330.98 | $24,944.33 | $37,315.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,271.81 / $21,377.52 / $36,371.37
| Facility | | $17,271.81 | $21,377.52 | $36,371.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,452.79 / $24,794.04 / $40,584.26
| Facility | | $15,452.79 | $24,794.04 | $40,584.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.53 / $14,233.61 / $20,709.21
| Facility | | $225.53 | $14,233.61 | $20,709.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,584.52 / $24,495.46 / $28,788.30
| Facility | | $17,584.52 | $24,495.46 | $28,788.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,870.02 / $26,127.98 / $32,936.44
| Facility | | $15,870.02 | $26,127.98 | $32,936.44 |