- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $17,782.79 / $28,183.83
| Facility | | $15,848.93 | $17,782.79 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $30,902.95 / $40,738.03
| Facility | | $21,877.62 | $30,902.95 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $25,118.86 / $34,673.69
| Facility | | $20,417.38 | $25,118.86 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $25,118.86 / $33,884.42
| Facility | | $15,135.61 | $25,118.86 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $23,442.29 / $35,481.34
| Facility | | $15,135.61 | $23,442.29 | $35,481.34 |