- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $26,302.68 / $33,113.11
| Facility | | $19,952.62 | $26,302.68 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $31,622.78 / $43,651.58
| Facility | | $20,892.96 | $31,622.78 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $27,542.29 / $36,307.81
| Facility | | $17,782.79 | $27,542.29 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $27,542.29 / $33,884.42
| Facility | | $18,620.87 | $27,542.29 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $30,199.52 / $43,651.58
| Facility | | $4,466.84 | $30,199.52 | $43,651.58 |