- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $25,703.96 / $28,840.32
| Facility | | $18,620.87 | $25,703.96 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $15,135.61 / $26,302.68
| Facility | | $14,791.08 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $23,988.33 / $31,622.78
| Facility | | $13,803.84 | $23,988.33 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $18,620.87 / $45,708.82
| Facility | | $12,302.69 | $18,620.87 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $18,197.01 / $26,915.35
| Facility | | $11,748.98 | $18,197.01 | $26,915.35 |