- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,769.30 / $23,027.90 / $30,266.60
| Facility | | $15,769.30 | $23,027.90 | $30,266.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,643.90 / $21,691.27 / $26,978.95
| Facility | | $15,643.90 | $21,691.27 | $26,978.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,766.50 / $15,704.36 / $26,561.80
| Facility | | $5,766.50 | $15,704.36 | $26,561.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,019.47 / $23,130.24 / $38,714.79
| Facility | | $16,019.47 | $23,130.24 | $38,714.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,835.66 / $25,813.65 / $37,690.03
| Facility | | $19,835.66 | $25,813.65 | $37,690.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,835.66 / $23,997.23 / $37,690.03
| Facility | | $19,835.66 | $23,997.23 | $37,690.03 |