- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $23,988.33 / $27,542.29
| Facility | | $15,135.61 | $23,988.33 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,118.86 / $33,884.42
| Facility | | $16,982.44 | $25,118.86 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $20,417.38 / $30,199.52
| Facility | | $14,125.38 | $20,417.38 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $21,379.62 / $28,183.83
| Facility | | $14,791.08 | $21,379.62 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $21,877.62 / $36,307.81
| Facility | | $4,073.80 | $21,877.62 | $36,307.81 |