- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $21,379.62 / $27,542.29
| Facility | | $15,488.17 | $21,379.62 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,054.61 / $26,302.68
| Facility | | $12,302.69 | $19,054.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $22,387.21 / $31,622.78
| Facility | | $11,748.98 | $22,387.21 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $21,877.62 / $26,915.35
| Facility | | $12,302.69 | $21,877.62 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $22,387.21 / $31,622.78
| Facility | | $11,220.18 | $22,387.21 | $31,622.78 |