- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,047.20 / $23,047.20 / $27,315.50
| Facility | | $23,047.20 | $23,047.20 | $27,315.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,346.58 / $26,596.77 / $39,787.15
| Facility | | $16,346.58 | $26,596.77 | $39,787.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,849.80 / $23,330.62 / $39,694.33
| Facility | | $18,849.80 | $23,330.62 | $39,694.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,864.59 / $27,059.28 / $44,292.14
| Facility | | $16,864.59 | $27,059.28 | $44,292.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.47 / $15,176.51 / $22,601.25
| Facility | | $240.47 | $15,176.51 | $22,601.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,191.08 / $26,733.42 / $31,418.47
| Facility | | $19,191.08 | $26,733.42 | $31,418.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,319.93 / $28,515.10 / $35,945.60
| Facility | | $17,319.93 | $28,515.10 | $35,945.60 |