- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $28,840.32 / $30,902.95
| Facility | | $16,982.44 | $28,840.32 | $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
- $15,848.93 / $22,908.68 / $33,884.42
| Facility | | $15,848.93 | $22,908.68 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $21,379.62 / $31,622.78
| Facility | | $15,488.17 | $21,379.62 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $24,547.09 / $40,738.03
| Facility | | $4,073.80 | $24,547.09 | $40,738.03 |