- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $26,915.35 / $40,738.03
| Facility | | $19,498.45 | $26,915.35 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $23,988.33 / $34,673.69
| Facility | | $14,454.40 | $23,988.33 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $22,908.68 / $41,686.94
| Facility | | $15,848.93 | $22,908.68 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $263.03 / $389.05
| Facility | | $165.96 | $263.03 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,703.96 / $38,018.94
| Facility | | $16,982.44 | $25,703.96 | $38,018.94 |