- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $17,782.79 / $28,840.32
| Facility | | $16,595.87 | $17,782.79 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $31,622.78 / $42,657.95
| Facility | | $22,387.21 | $31,622.78 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $25,703.96 / $36,307.81
| Facility | | $20,892.96 | $25,703.96 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $25,703.96 / $34,673.69
| Facility | | $15,488.17 | $25,703.96 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $26,302.68 / $36,307.81
| Facility | | $15,848.93 | $26,302.68 | $36,307.81 |