- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,937.50 / $22,937.50 / $27,185.40
| Facility | | $22,937.50 | $22,937.50 | $27,185.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,868.55 / $27,446.04 / $41,057.60
| Facility | | $16,868.55 | $27,446.04 | $41,057.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,760.02 / $23,219.49 / $39,505.26
| Facility | | $18,760.02 | $23,219.49 | $39,505.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,784.25 / $26,930.39 / $44,081.17
| Facility | | $16,784.25 | $26,930.39 | $44,081.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.14 / $15,661.12 / $22,493.60
| Facility | | $248.14 | $15,661.12 | $22,493.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,099.66 / $26,606.08 / $31,268.82
| Facility | | $19,099.66 | $26,606.08 | $31,268.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,237.45 / $28,379.27 / $35,774.39
| Facility | | $17,237.45 | $28,379.27 | $35,774.39 |