- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,087.40 / $17,764.30 / $27,426.50
| Facility | | $12,087.40 | $17,764.30 | $27,426.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,229.68 / $28,759.50 / $36,871.16
| Facility | | $20,229.68 | $28,759.50 | $36,871.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,603.98 / $26,302.02 / $33,267.30
| Facility | | $13,603.98 | $26,302.02 | $33,267.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,087.40 / $18,169.80 / $29,054.30
| Facility | | $12,087.40 | $18,169.80 | $29,054.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,908.69 / $24,172.94 / $36,725.72
| Facility | | $15,908.69 | $24,172.94 | $36,725.72 |