- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $26,302.68 / $30,902.95
| Facility | | $16,982.44 | $26,302.68 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $28,183.83 / $39,810.72
| Facility | | $19,054.61 | $28,183.83 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $25,703.96 / $34,673.69
| Facility | | $15,848.93 | $25,703.96 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $24,547.09 / $30,902.95
| Facility | | $16,982.44 | $24,547.09 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $12,882.50 / $40,738.03
| Facility | | $4,466.84 | $12,882.50 | $40,738.03 |