- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $29,512.09 / $38,018.94
| Facility | | $20,892.96 | $29,512.09 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $25,703.96 / $35,481.34
| Facility | | $17,782.79 | $25,703.96 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $30,902.95 / $43,651.58
| Facility | | $16,218.10 | $30,902.95 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $34,673.69 / $39,810.72
| Facility | | $18,197.01 | $34,673.69 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $30,902.95 / $43,651.58
| Facility | | $14,791.08 | $30,902.95 | $43,651.58 |