- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,934.00 / $28,484.90 / $39,572.40
| Facility | | $22,934.00 | $28,484.90 | $39,572.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,235.42 / $22,235.42 / $33,817.43
| Facility | | $22,235.42 | $22,235.42 | $33,817.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,270.52 / $26,071.20 / $39,498.44
| Facility | | $16,270.52 | $26,071.20 | $39,498.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,896.95 / $26,157.13 / $40,517.47
| Facility | | $16,896.95 | $26,157.13 | $40,517.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,590.91 / $26,157.13 / $40,517.47
| Facility | | $17,590.91 | $26,157.13 | $40,517.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $30,946.57 / $43,510.63
| Facility | | $10,403.00 | $30,946.57 | $43,510.63 |