- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $30,199.52 / $33,884.42
| Facility | | $18,620.87 | $30,199.52 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $30,902.95 / $42,657.95
| Facility | | $20,892.96 | $30,902.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $25,118.86 / $37,153.52
| Facility | | $15,848.93 | $25,118.86 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $23,988.33 / $33,884.42
| Facility | | $15,488.17 | $23,988.33 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $29,512.09 / $44,668.36
| Facility | | $4,073.80 | $29,512.09 | $44,668.36 |