- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $30,902.95 / $35,481.34
| Facility | | $22,387.21 | $30,902.95 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $21,379.62 / $39,810.72
| Facility | | $19,054.61 | $21,379.62 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $29,512.09 / $38,904.51
| Facility | | $16,595.87 | $29,512.09 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $22,387.21 / $54,954.09
| Facility | | $14,791.08 | $22,387.21 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $21,877.62 / $33,113.11
| Facility | | $13,803.84 | $21,877.62 | $33,113.11 |