- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $17,782.79 / $28,183.83
| Facility | | $16,218.10 | $17,782.79 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $26,915.35 / $38,018.94
| Facility | | $19,952.62 | $26,915.35 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $24,547.09 / $35,481.34
| Facility | | $18,620.87 | $24,547.09 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $25,118.86 / $33,884.42
| Facility | | $15,488.17 | $25,118.86 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $25,118.86 / $35,481.34
| Facility | | $15,848.93 | $25,118.86 | $35,481.34 |