- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,486.40 / $22,614.80 / $29,723.60
| Facility | | $15,486.40 | $22,614.80 | $29,723.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,314.39 / $25,366.61 / $42,904.20
| Facility | | $9,314.39 | $25,366.61 | $42,904.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,732.06 / $22,715.25 / $38,020.19
| Facility | | $15,732.06 | $22,715.25 | $38,020.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,479.78 / $25,350.52 / $37,013.82
| Facility | | $19,479.78 | $25,350.52 | $37,013.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,479.78 / $23,566.69 / $37,013.82
| Facility | | $19,479.78 | $23,566.69 | $37,013.82 |