- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,632.20 / $22,632.20 / $26,823.60
| Facility | | $22,632.20 | $22,632.20 | $26,823.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,936.86 / $25,930.12 / $38,789.87
| Facility | | $15,936.86 | $25,930.12 | $38,789.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,510.34 / $22,910.46 / $38,979.50
| Facility | | $18,510.34 | $22,910.46 | $38,979.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,560.88 / $26,571.98 / $43,494.50
| Facility | | $16,560.88 | $26,571.98 | $43,494.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.44 / $14,796.11 / $22,194.24
| Facility | | $234.44 | $14,796.11 | $22,194.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,845.47 / $26,251.99 / $30,852.67
| Facility | | $18,845.47 | $26,251.99 | $30,852.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,008.04 / $28,001.58 / $35,298.26
| Facility | | $17,008.04 | $28,001.58 | $35,298.26 |