- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $23,442.29 / $30,199.52
| Facility | | $16,595.87 | $23,442.29 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $20,417.38 / $28,183.83
| Facility | | $13,182.57 | $20,417.38 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $24,547.09 / $34,673.69
| Facility | | $12,882.50 | $24,547.09 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $22,908.68 / $28,840.32
| Facility | | $13,182.57 | $22,908.68 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $24,547.09 / $34,673.69
| Facility | | $12,022.64 | $24,547.09 | $34,673.69 |