- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $19,054.61 / $30,902.95
| Facility | | $17,782.79 | $19,054.61 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $33,884.42 / $45,708.82
| Facility | | $23,988.33 | $33,884.42 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $27,542.29 / $38,904.51
| Facility | | $22,908.68 | $27,542.29 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $27,542.29 / $37,153.52
| Facility | | $16,982.44 | $27,542.29 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,703.96 / $38,904.51
| Facility | | $16,982.44 | $25,703.96 | $38,904.51 |