- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $21,877.62 / $36,307.81
| Facility | | $14,454.40 | $21,877.62 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $16,982.44 / $28,840.32
| Facility | | $12,589.25 | $16,982.44 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,595.87 / $21,379.62
| Facility | | $11,748.98 | $16,595.87 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,054.61 / $27,542.29
| Facility | | $12,589.25 | $19,054.61 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,054.61 / $26,302.68
| Facility | | $14,454.40 | $19,054.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $19,498.45 / $27,542.29
| Facility | | $6,760.83 | $19,498.45 | $27,542.29 |