- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,713.40 / $21,713.40 / $25,734.60
| Facility | | $21,713.40 | $21,713.40 | $25,734.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,933.24 / $24,297.19 / $36,347.11
| Facility | | $14,933.24 | $24,297.19 | $36,347.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,758.86 / $21,980.35 / $37,397.01
| Facility | | $17,758.86 | $21,980.35 | $37,397.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,888.55 / $25,493.21 / $41,728.71
| Facility | | $15,888.55 | $25,493.21 | $41,728.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.68 / $13,864.34 / $21,293.19
| Facility | | $219.68 | $13,864.34 | $21,293.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,080.39 / $25,186.21 / $29,600.11
| Facility | | $18,080.39 | $25,186.21 | $29,600.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,882.90 / $27,363.35 / $36,022.42
| Facility | | $15,882.90 | $27,363.35 | $36,022.42 |