- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $26,915.35 / $40,738.03
| Facility | | $19,498.45 | $26,915.35 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $23,442.29 / $34,673.69
| Facility | | $15,135.61 | $23,442.29 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $23,442.29 / $41,686.94
| Facility | | $16,595.87 | $23,442.29 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $263.03 / $389.05
| Facility | | $165.96 | $263.03 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $25,703.96 / $38,018.94
| Facility | | $16,595.87 | $25,703.96 | $38,018.94 |