- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $23,988.33 / $30,902.95
| Facility | | $16,982.44 | $23,988.33 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $20,892.96 / $28,840.32
| Facility | | $14,454.40 | $20,892.96 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $25,118.86 / $35,481.34
| Facility | | $13,182.57 | $25,118.86 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $22,387.21 / $28,840.32
| Facility | | $14,454.40 | $22,387.21 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $25,118.86 / $35,481.34
| Facility | | $12,302.69 | $25,118.86 | $35,481.34 |