- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,974.20 / $24,787.40 / $32,579.20
| Facility | | $16,974.20 | $24,787.40 | $32,579.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,783.42 / $21,197.18 / $35,852.17
| Facility | | $7,783.42 | $21,197.18 | $35,852.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,243.50 / $24,897.59 / $41,672.94
| Facility | | $17,243.50 | $24,897.59 | $41,672.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,351.28 / $27,786.04 / $40,569.89
| Facility | | $21,351.28 | $27,786.04 | $40,569.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,351.28 / $25,830.83 / $40,569.89
| Facility | | $21,351.28 | $25,830.83 | $40,569.89 |