- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,703.96 / $42,657.95
| Facility | | $16,982.44 | $25,703.96 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $20,417.38 / $33,884.42
| Facility | | $14,791.08 | $20,417.38 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $17,782.79 / $22,387.21
| Facility | | $14,125.38 | $17,782.79 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $22,387.21 / $33,113.11
| Facility | | $14,125.38 | $22,387.21 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $21,379.62 / $28,840.32
| Facility | | $15,848.93 | $21,379.62 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $22,908.68 / $31,622.78
| Facility | | $7,943.28 | $22,908.68 | $31,622.78 |