- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $17,782.79 / $29,512.09
| Facility | | $16,595.87 | $17,782.79 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $32,359.37 / $42,657.95
| Facility | | $22,908.68 | $32,359.37 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $26,302.68 / $37,153.52
| Facility | | $21,379.62 | $26,302.68 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $26,302.68 / $35,481.34
| Facility | | $15,848.93 | $26,302.68 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $24,547.09 / $37,153.52
| Facility | | $15,848.93 | $24,547.09 | $37,153.52 |