- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $15,135.61 / $21,877.62
| Facility | | $12,302.69 | $15,135.61 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $23,988.33 / $32,359.37
| Facility | | $16,982.44 | $23,988.33 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $19,498.45 / $27,542.29
| Facility | | $15,848.93 | $19,498.45 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $19,498.45 / $26,302.68
| Facility | | $11,748.98 | $19,498.45 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $18,197.01 / $27,542.29
| Facility | | $11,748.98 | $18,197.01 | $27,542.29 |