- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $30,902.95 / $41,686.94
| Facility | | $16,218.10 | $30,902.95 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $25,703.96 / $40,738.03
| Facility | | $17,378.01 | $25,703.96 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $33,113.11 / $44,668.36
| Facility | | $15,848.93 | $33,113.11 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $23,442.29 / $44,668.36
| Facility | | $7,943.28 | $23,442.29 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $23,442.29 / $46,773.51
| Facility | | $6,456.54 | $23,442.29 | $46,773.51 |