- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $31,622.78 / $33,884.42
| Facility | | $18,620.87 | $31,622.78 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $31,622.78 / $43,651.58
| Facility | | $20,892.96 | $31,622.78 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $28,183.83 / $37,153.52
| Facility | | $17,782.79 | $28,183.83 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $26,915.35 / $34,673.69
| Facility | | $19,054.61 | $26,915.35 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $26,915.35 / $44,668.36
| Facility | | $4,073.80 | $26,915.35 | $44,668.36 |