- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $21,877.62 / $30,902.95
| Facility | | $14,454.40 | $21,877.62 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $17,782.79 / $29,512.09
| Facility | | $6,606.93 | $17,782.79 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $17,782.79 / $30,199.52
| Facility | | $12,882.50 | $17,782.79 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $19,952.62 / $28,840.32
| Facility | | $16,218.10 | $19,952.62 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $19,498.45 / $28,183.83
| Facility | | $10,232.93 | $19,498.45 | $28,183.83 |