- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $26,302.68 / $30,902.95
| Facility | | $16,982.44 | $26,302.68 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $28,840.32 / $39,810.72
| Facility | | $19,054.61 | $28,840.32 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $25,703.96 / $34,673.69
| Facility | | $16,218.10 | $25,703.96 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,118.86 / $31,622.78
| Facility | | $16,982.44 | $25,118.86 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $27,542.29 / $41,686.94
| Facility | | $4,073.80 | $27,542.29 | $41,686.94 |