- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $25,703.96 / $30,199.52
| Facility | | $16,595.87 | $25,703.96 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $28,183.83 / $38,904.51
| Facility | | $18,620.87 | $28,183.83 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $25,118.86 / $34,673.69
| Facility | | $15,488.17 | $25,118.86 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $24,547.09 / $30,902.95
| Facility | | $16,595.87 | $24,547.09 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $23,988.33 / $39,810.72
| Facility | | $4,073.80 | $23,988.33 | $39,810.72 |