- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $31,622.78 / $42,657.95
| Facility | | $21,379.62 | $31,622.78 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $32,359.37 / $72,443.60
| Facility | | $17,782.79 | $32,359.37 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $32,359.37 / $41,686.94
| Facility | | $15,135.61 | $32,359.37 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $27,542.29 / $39,810.72
| Facility | | $17,782.79 | $27,542.29 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,982.44 / $36,307.81
| Facility | | $6,165.95 | $16,982.44 | $36,307.81 |