- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,615.50 / $25,723.90 / $33,810.10
| Facility | | $17,615.50 | $25,723.90 | $33,810.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,437.33 / $33,871.54 / $57,289.14
| Facility | | $12,437.33 | $33,871.54 | $57,289.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,541.16 / $25,957.31 / $46,300.51
| Facility | | $18,541.16 | $25,957.31 | $46,300.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,157.94 / $28,835.81 / $42,102.63
| Facility | | $22,157.94 | $28,835.81 | $42,102.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,157.94 / $26,806.73 / $42,102.63
| Facility | | $22,157.94 | $26,806.73 | $42,102.63 |