- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $27,542.29 / $45,708.82
| Facility | | $20,417.38 | $27,542.29 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $24,547.09 / $38,018.94
| Facility | | $16,982.44 | $24,547.09 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $30,902.95 / $45,708.82
| Facility | | $19,054.61 | $30,902.95 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $26,302.68 / $42,657.95
| Facility | | $16,595.87 | $26,302.68 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $19,054.61 / $32,359.37
| Facility | | $12,022.64 | $19,054.61 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $30,902.95 / $42,657.95
| Facility | | $9,120.11 | $30,902.95 | $42,657.95 |