- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,527.50 / $22,674.70 / $29,802.40
| Facility | | $15,527.50 | $22,674.70 | $29,802.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,221.55 / $30,560.52 / $51,689.00
| Facility | | $11,221.55 | $30,560.52 | $51,689.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,343.36 / $22,880.43 / $40,812.22
| Facility | | $16,343.36 | $22,880.43 | $40,812.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,531.41 / $25,417.72 / $37,111.94
| Facility | | $19,531.41 | $25,417.72 | $37,111.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,531.41 / $23,629.16 / $37,111.94
| Facility | | $19,531.41 | $23,629.16 | $37,111.94 |