- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $27,542.29 / $35,481.34
| Facility | | $19,952.62 | $27,542.29 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $24,547.09 / $33,884.42
| Facility | | $16,595.87 | $24,547.09 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $28,840.32 / $40,738.03
| Facility | | $15,135.61 | $28,840.32 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,703.96 / $33,884.42
| Facility | | $16,982.44 | $25,703.96 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $28,840.32 / $40,738.03
| Facility | | $14,125.38 | $28,840.32 | $40,738.03 |