- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,680.10 / $25,058.30 / $40,730.30
| Facility | | $14,680.10 | $25,058.30 | $40,730.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,207.23 / $21,036.69 / $26,359.80
| Facility | | $18,207.23 | $21,036.69 | $26,359.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,588.08 / $22,414.00 / $32,316.62
| Facility | | $12,588.08 | $22,414.00 | $32,316.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,770.37 / $18,120.57 / $35,945.16
| Facility | | $8,770.37 | $18,120.57 | $35,945.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,161.00 / $22,659.75 / $30,277.52
| Facility | | $15,161.00 | $22,659.75 | $30,277.52 |