- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $22,908.68 / $38,904.51
| Facility | | $15,488.17 | $22,908.68 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $18,197.01 / $30,199.52
| Facility | | $13,489.63 | $18,197.01 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $17,378.01 / $22,387.21
| Facility | | $13,182.57 | $17,378.01 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $20,892.96 / $30,902.95
| Facility | | $14,454.40 | $20,892.96 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $20,892.96 / $29,512.09
| Facility | | $16,218.10 | $20,892.96 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $20,892.96 / $28,840.32
| Facility | | $7,079.46 | $20,892.96 | $28,840.32 |