- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $17,782.79 / $25,703.96
| Facility | | $14,791.08 | $17,782.79 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $28,840.32 / $38,018.94
| Facility | | $19,952.62 | $28,840.32 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $23,442.29 / $32,359.37
| Facility | | $19,054.61 | $23,442.29 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $23,988.33 / $30,902.95
| Facility | | $14,125.38 | $23,988.33 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $21,877.62 / $33,113.11
| Facility | | $14,125.38 | $21,877.62 | $33,113.11 |