- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $24,547.09 / $28,183.83
| Facility | | $17,782.79 | $24,547.09 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $16,218.10 / $20,417.38
| Facility | | $12,882.50 | $16,218.10 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $23,442.29 / $30,902.95
| Facility | | $13,489.63 | $23,442.29 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $17,782.79 / $44,668.36
| Facility | | $11,748.98 | $17,782.79 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $17,782.79 / $26,302.68
| Facility | | $11,481.54 | $17,782.79 | $26,302.68 |