- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,521.10 / $21,205.20 / $27,870.90
| Facility | | $14,521.10 | $21,205.20 | $27,870.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,649.25 / $18,108.41 / $30,627.96
| Facility | | $6,649.25 | $18,108.41 | $30,627.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,284.17 / $21,397.57 / $38,167.23
| Facility | | $15,284.17 | $21,397.57 | $38,167.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,265.61 / $23,770.43 / $34,706.76
| Facility | | $18,265.61 | $23,770.43 | $34,706.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,265.61 / $22,097.78 / $34,706.76
| Facility | | $18,265.61 | $22,097.78 | $34,706.76 |