- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,393.90 / $19,559.09 / $25,707.30
| Facility | | $13,393.90 | $19,559.09 | $25,707.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,743.99 / $15,643.04 / $26,458.10
| Facility | | $5,743.99 | $15,643.04 | $26,458.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,606.35 / $19,645.97 / $32,882.92
| Facility | | $13,606.35 | $19,645.97 | $32,882.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,847.68 / $21,925.17 / $32,012.53
| Facility | | $16,847.68 | $21,925.17 | $32,012.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,847.68 / $20,382.36 / $32,012.53
| Facility | | $16,847.68 | $20,382.36 | $32,012.53 |