- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,525.20 / $22,671.50 / $29,798.10
| Facility | | $15,525.20 | $22,671.50 | $29,798.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,806.94 / $34,878.12 / $58,991.66
| Facility | | $12,806.94 | $34,878.12 | $58,991.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,341.03 / $22,877.16 / $41,541.01
| Facility | | $16,341.03 | $22,877.16 | $41,541.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,528.63 / $25,414.09 / $37,106.64
| Facility | | $19,528.63 | $25,414.09 | $37,106.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,528.63 / $23,625.78 / $37,106.64
| Facility | | $19,528.63 | $23,625.78 | $37,106.64 |