- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,566.83 / $17,757.91 / $17,757.91
| Facility | | $15,566.83 | $17,757.91 | $17,757.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,526.57 / $20,345.65 / $39,400.39
| Facility | | $12,526.57 | $20,345.65 | $39,400.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,811.00 / $26,912.00 / $37,725.39
| Facility | | $21,811.00 | $26,912.00 | $37,725.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,208.32 / $26,427.40 / $38,824.89
| Facility | | $17,208.32 | $26,427.40 | $38,824.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,522.87 / $21,522.87 / $37,455.72
| Facility | | $21,522.87 | $21,522.87 | $37,455.72 |