- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $24,547.09 / $38,018.94
| Facility | | $17,782.79 | $24,547.09 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $21,877.62 / $31,622.78
| Facility | | $13,803.84 | $21,877.62 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $21,379.62 / $38,018.94
| Facility | | $15,135.61 | $21,379.62 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $239.88 / $380.19
| Facility | | $158.49 | $239.88 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $22,387.21 / $33,884.42
| Facility | | $14,454.40 | $22,387.21 | $33,884.42 |