- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $25,118.86 / $38,018.94
| Facility | | $18,197.01 | $25,118.86 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $21,877.62 / $32,359.37
| Facility | | $13,803.84 | $21,877.62 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $21,877.62 / $38,904.51
| Facility | | $15,488.17 | $21,877.62 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $245.47 / $363.08
| Facility | | $154.88 | $245.47 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $23,988.33 / $35,481.34
| Facility | | $15,488.17 | $23,988.33 | $35,481.34 |