- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,115.80 / $22,073.60 / $29,012.30
| Facility | | $15,115.80 | $22,073.60 | $29,012.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,522.64 / $23,210.36 / $39,257.19
| Facility | | $8,522.64 | $23,210.36 | $39,257.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,355.61 / $22,171.70 / $37,110.41
| Facility | | $15,355.61 | $22,171.70 | $37,110.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,013.65 / $24,743.91 / $36,128.12
| Facility | | $19,013.65 | $24,743.91 | $36,128.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,013.65 / $23,002.76 / $36,128.12
| Facility | | $19,013.65 | $23,002.76 | $36,128.12 |