- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,753.80 / $28,857.20 / $40,858.69
| Facility | | $15,753.80 | $28,857.20 | $40,858.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,030.66 / $27,323.27 / $42,919.34
| Facility | | $17,030.66 | $27,323.27 | $42,919.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,379.22 / $25,958.58 / $46,184.44
| Facility | | $16,379.22 | $25,958.58 | $46,184.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $24,761.66 / $54,613.18
| Facility | | $7,117.00 | $24,761.66 | $54,613.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,520.00 / $25,941.06 / $48,532.13
| Facility | | $6,520.00 | $25,941.06 | $48,532.13 |