- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $25,118.86 / $28,840.32
| Facility | | $19,498.45 | $25,118.86 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $21,877.62 / $31,622.78
| Facility | | $21,877.62 | $21,877.62 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $23,988.33 / $28,840.32
| Facility | | $20,417.38 | $23,988.33 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $28,840.32 / $35,481.34
| Facility | | $17,782.79 | $28,840.32 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $25,118.86 / $36,307.81
| Facility | | $25,118.86 | $25,118.86 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $28,183.83 / $37,153.52
| Facility | | $1,862.09 | $28,183.83 | $37,153.52 |