- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $14,454.40 / $21,379.62
| Facility | | $12,022.64 | $14,454.40 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $23,442.29 / $30,902.95
| Facility | | $16,595.87 | $23,442.29 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $19,054.61 / $26,915.35
| Facility | | $15,488.17 | $19,054.61 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $19,054.61 / $25,703.96
| Facility | | $11,481.54 | $19,054.61 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $17,782.79 / $26,915.35
| Facility | | $11,481.54 | $17,782.79 | $26,915.35 |