- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $25,703.96 / $43,651.58
| Facility | | $17,378.01 | $25,703.96 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $20,417.38 / $33,884.42
| Facility | | $14,791.08 | $20,417.38 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $16,982.44 / $21,877.62
| Facility | | $12,882.50 | $16,982.44 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $20,417.38 / $30,199.52
| Facility | | $13,489.63 | $20,417.38 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $20,417.38 / $27,542.29
| Facility | | $15,135.61 | $20,417.38 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $23,442.29 / $32,359.37
| Facility | | $7,943.28 | $23,442.29 | $32,359.37 |