- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $19,498.45 / $33,884.42
| Facility | | $15,488.17 | $19,498.45 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $31,622.78 / $33,884.42
| Facility | | $19,054.61 | $31,622.78 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $19,952.62 / $32,359.37
| Facility | | $11,748.98 | $19,952.62 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $26,302.68 / $34,673.69
| Facility | | $16,595.87 | $26,302.68 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $25,703.96 / $39,810.72
| Facility | | $14,791.08 | $25,703.96 | $39,810.72 |