- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,672.70 / $19,672.70 / $23,316.00
| Facility | | $19,672.70 | $19,672.70 | $23,316.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,846.81 / $22,529.51 / $33,702.76
| Facility | | $13,846.81 | $22,529.51 | $33,702.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,089.85 / $19,914.59 / $33,882.37
| Facility | | $16,089.85 | $19,914.59 | $33,882.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,395.32 / $23,097.32 / $37,806.98
| Facility | | $14,395.32 | $23,097.32 | $37,806.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.69 / $12,855.67 / $19,292.03
| Facility | | $203.69 | $12,855.67 | $19,292.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,381.16 / $22,819.17 / $26,818.24
| Facility | | $16,381.16 | $22,819.17 | $26,818.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,783.99 / $24,339.98 / $30,682.52
| Facility | | $14,783.99 | $24,339.98 | $30,682.52 |