- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,358.40 / $19,507.20 / $25,639.20
| Facility | | $13,358.40 | $19,507.20 | $25,639.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,147.37 / $16,741.59 / $28,316.17
| Facility | | $6,147.37 | $16,741.59 | $28,316.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,570.28 / $19,593.90 / $32,795.76
| Facility | | $13,570.28 | $19,593.90 | $32,795.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,803.02 / $21,867.05 / $31,927.67
| Facility | | $16,803.02 | $21,867.05 | $31,927.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,803.02 / $20,328.34 / $31,927.67
| Facility | | $16,803.02 | $20,328.34 | $31,927.67 |