- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,307.40 / $22,307.40 / $26,438.60
| Facility | | $22,307.40 | $22,307.40 | $26,438.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,960.43 / $29,222.58 / $43,715.20
| Facility | | $17,960.43 | $29,222.58 | $43,715.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,244.68 / $22,581.65 / $38,420.06
| Facility | | $18,244.68 | $22,581.65 | $38,420.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,323.20 / $26,190.61 / $42,870.26
| Facility | | $16,323.20 | $26,190.61 | $42,870.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.20 / $16,674.84 / $23,824.34
| Facility | | $264.20 | $16,674.84 | $23,824.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,575.00 / $25,875.21 / $30,409.86
| Facility | | $18,575.00 | $25,875.21 | $30,409.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,763.93 / $27,599.70 / $34,791.66
| Facility | | $16,763.93 | $27,599.70 | $34,791.66 |