- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,802.30 / $24,536.30 / $32,249.10
| Facility | | $16,802.30 | $24,536.30 | $32,249.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,316.23 / $17,201.47 / $29,093.97
| Facility | | $6,316.23 | $17,201.47 | $29,093.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,685.16 / $24,758.93 / $44,162.93
| Facility | | $17,685.16 | $24,758.93 | $44,162.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,134.97 / $27,504.53 / $40,158.86
| Facility | | $21,134.97 | $27,504.53 | $40,158.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,134.97 / $25,569.13 / $40,158.86
| Facility | | $21,134.97 | $25,569.13 | $40,158.86 |