- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,951.40 / $21,804.10 / $35,394.90
| Facility | | $14,951.40 | $21,804.10 | $35,394.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,497.99 / $31,984.25 / $41,005.44
| Facility | | $22,497.99 | $31,984.25 | $41,005.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,556.46 / $33,943.76 / $42,658.84
| Facility | | $17,556.46 | $33,943.76 | $42,658.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,599.30 / $23,448.80 / $37,495.60
| Facility | | $15,599.30 | $23,448.80 | $37,495.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,243.20 / $31,196.10 / $47,395.94
| Facility | | $18,243.20 | $31,196.10 | $47,395.94 |