- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $25,118.86 / $31,622.78
| Facility | | $18,197.01 | $25,118.86 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $28,840.32 / $40,738.03
| Facility | | $20,892.96 | $28,840.32 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,703.96 / $34,673.69
| Facility | | $16,982.44 | $25,703.96 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $24,547.09 / $30,902.95
| Facility | | $17,782.79 | $24,547.09 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $28,840.32 / $46,773.51
| Facility | | $4,466.84 | $28,840.32 | $46,773.51 |