- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,946.40 / $20,946.40 / $24,825.70
| Facility | | $20,946.40 | $20,946.40 | $24,825.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,039.69 / $22,843.33 / $34,172.23
| Facility | | $14,039.69 | $22,843.33 | $34,172.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,131.59 / $21,203.98 / $36,076.11
| Facility | | $17,131.59 | $21,203.98 | $36,076.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,327.35 / $24,592.76 / $40,254.81
| Facility | | $15,327.35 | $24,592.76 | $40,254.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.53 / $13,034.74 / $20,541.09
| Facility | | $206.53 | $13,034.74 | $20,541.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,441.77 / $24,296.61 / $28,554.60
| Facility | | $17,441.77 | $24,296.61 | $28,554.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,741.19 / $25,915.88 / $32,669.08
| Facility | | $15,741.19 | $25,915.88 | $32,669.08 |