- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,555.59 / $25,636.40 / $33,695.10
| Facility | | $17,555.59 | $25,636.40 | $33,695.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,247.78 / $22,461.80 / $37,991.11
| Facility | | $8,247.78 | $22,461.80 | $37,991.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,834.09 / $25,750.35 / $43,100.27
| Facility | | $17,834.09 | $25,750.35 | $43,100.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,082.58 / $28,737.73 / $41,959.43
| Facility | | $22,082.58 | $28,737.73 | $41,959.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,082.58 / $26,715.55 / $41,959.43
| Facility | | $22,082.58 | $26,715.55 | $41,959.43 |