- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,054.61 / $22,387.21
| Facility | | $12,302.69 | $19,054.61 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $20,417.38 / $28,183.83
| Facility | | $13,803.84 | $20,417.38 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $17,782.79 / $28,840.32
| Facility | | $11,481.54 | $17,782.79 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $19,054.61 / $26,915.35
| Facility | | $13,803.84 | $19,054.61 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $19,498.45 / $29,512.09
| Facility | | $4,073.80 | $19,498.45 | $29,512.09 |