- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $24,547.09 / $31,622.78
| Facility | | $17,782.79 | $24,547.09 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $21,877.62 / $30,199.52
| Facility | | $13,803.84 | $21,877.62 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $25,703.96 / $36,307.81
| Facility | | $13,489.63 | $25,703.96 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $22,387.21 / $25,703.96
| Facility | | $13,803.84 | $22,387.21 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $25,703.96 / $36,307.81
| Facility | | $12,589.25 | $25,703.96 | $36,307.81 |