- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $17,782.79 / $26,915.35
| Facility | | $15,135.61 | $17,782.79 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $25,703.96 / $35,481.34
| Facility | | $18,620.87 | $25,703.96 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $22,908.68 / $33,113.11
| Facility | | $17,782.79 | $22,908.68 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $23,988.33 / $31,622.78
| Facility | | $14,454.40 | $23,988.33 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $23,988.33 / $33,884.42
| Facility | | $14,791.08 | $23,988.33 | $33,884.42 |