- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,932.80 / $21,806.30 / $28,660.90
| Facility | | $14,932.80 | $21,806.30 | $28,660.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,865.94 / $16,105.23 / $27,019.84
| Facility | | $5,865.94 | $16,105.23 | $27,019.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,717.42 / $22,004.12 / $39,249.14
| Facility | | $15,717.42 | $22,004.12 | $39,249.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,783.38 / $24,444.24 / $35,690.58
| Facility | | $18,783.38 | $24,444.24 | $35,690.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,783.38 / $22,724.18 / $35,690.58
| Facility | | $18,783.38 | $22,724.18 | $35,690.58 |