- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $26,302.68 / $33,884.42
| Facility | | $18,620.87 | $26,302.68 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $22,908.68 / $31,622.78
| Facility | | $14,791.08 | $22,908.68 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $27,542.29 / $38,018.94
| Facility | | $14,454.40 | $27,542.29 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $25,118.86 / $33,113.11
| Facility | | $14,791.08 | $25,118.86 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $27,542.29 / $38,018.94
| Facility | | $13,182.57 | $27,542.29 | $38,018.94 |