- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $21,877.62 / $37,153.52
| Facility | | $14,791.08 | $21,877.62 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $17,378.01 / $28,840.32
| Facility | | $12,589.25 | $17,378.01 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $14,454.40 / $19,054.61
| Facility | | $10,964.78 | $14,454.40 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $17,378.01 / $25,703.96
| Facility | | $11,481.54 | $17,378.01 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $16,982.44 / $23,442.29
| Facility | | $12,882.50 | $16,982.44 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $19,952.62 / $28,183.83
| Facility | | $6,760.83 | $19,952.62 | $28,183.83 |