- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,021.40 / $17,554.90 / $23,073.10
| Facility | | $12,021.40 | $17,554.90 | $23,073.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,151.12 / $16,751.82 / $28,333.45
| Facility | | $6,151.12 | $16,751.82 | $28,333.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,212.13 / $17,632.88 / $29,513.46
| Facility | | $12,212.13 | $17,632.88 | $29,513.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,121.33 / $19,678.53 / $28,732.25
| Facility | | $15,121.33 | $19,678.53 | $28,732.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,121.33 / $18,293.81 / $28,732.25
| Facility | | $15,121.33 | $18,293.81 | $28,732.25 |