- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $17,378.01 / $25,118.86
| Facility | | $14,454.40 | $17,378.01 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $27,542.29 / $37,153.52
| Facility | | $19,498.45 | $27,542.29 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $22,387.21 / $31,622.78
| Facility | | $18,197.01 | $22,387.21 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $22,387.21 / $30,199.52
| Facility | | $13,489.63 | $22,387.21 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $20,892.96 / $31,622.78
| Facility | | $13,489.63 | $20,892.96 | $31,622.78 |