- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $31,622.78 / $40,738.03
| Facility | | $22,387.21 | $31,622.78 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $27,542.29 / $38,018.94
| Facility | | $19,054.61 | $27,542.29 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $33,113.11 / $45,708.82
| Facility | | $17,378.01 | $33,113.11 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $29,512.09 / $37,153.52
| Facility | | $19,054.61 | $29,512.09 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $33,113.11 / $45,708.82
| Facility | | $15,848.93 | $33,113.11 | $45,708.82 |