- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $28,183.83 / $39,810.72
| Facility | | $18,620.87 | $28,183.83 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $34,673.69 / $58,884.37
| Facility | | $12,882.50 | $34,673.69 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $22,387.21 / $38,018.94
| Facility | | $16,595.87 | $22,387.21 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $26,302.68 / $37,153.52
| Facility | | $20,417.38 | $26,302.68 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $24,547.09 / $38,018.94
| Facility | | $12,882.50 | $24,547.09 | $38,018.94 |