- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $25,703.96 / $26,915.35
| Facility | | $21,877.62 | $25,703.96 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $27,542.29 / $39,810.72
| Facility | | $15,848.93 | $27,542.29 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $22,908.68 / $40,738.03
| Facility | | $16,595.87 | $22,908.68 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $21,877.62 / $27,542.29
| Facility | | $19,054.61 | $21,877.62 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $25,703.96 / $41,686.94
| Facility | | $15,848.93 | $25,703.96 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $16,595.87 / $21,379.62
| Facility | | $181.97 | $16,595.87 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $29,512.09 / $30,902.95
| Facility | | $23,988.33 | $29,512.09 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $27,542.29 / $37,153.52
| Facility | | $15,848.93 | $27,542.29 | $37,153.52 |