- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,514.90 / $22,514.90 / $26,684.60
| Facility | | $22,514.90 | $22,514.90 | $26,684.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,714.16 / $28,821.88 / $43,115.78
| Facility | | $17,714.16 | $28,821.88 | $43,115.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,414.41 / $22,791.73 / $38,777.48
| Facility | | $18,414.41 | $22,791.73 | $38,777.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,475.05 / $26,434.26 / $43,269.08
| Facility | | $16,475.05 | $26,434.26 | $43,269.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $260.58 / $16,446.20 / $23,497.66
| Facility | | $260.58 | $16,446.20 | $23,497.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,747.80 / $26,115.93 / $30,692.76
| Facility | | $18,747.80 | $26,115.93 | $30,692.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,919.89 / $27,856.45 / $35,115.33
| Facility | | $16,919.89 | $27,856.45 | $35,115.33 |