- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $15,488.17 / $22,908.68
| Facility | | $12,882.50 | $15,488.17 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $25,118.86 / $33,113.11
| Facility | | $17,378.01 | $25,118.86 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $20,417.38 / $28,183.83
| Facility | | $16,595.87 | $20,417.38 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $20,417.38 / $26,915.35
| Facility | | $12,302.69 | $20,417.38 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,054.61 / $28,840.32
| Facility | | $12,302.69 | $19,054.61 | $28,840.32 |