- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $17,782.79 / $27,542.29
| Facility | | $15,488.17 | $17,782.79 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $30,199.52 / $39,810.72
| Facility | | $21,379.62 | $30,199.52 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $24,547.09 / $34,673.69
| Facility | | $19,952.62 | $24,547.09 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $24,547.09 / $33,113.11
| Facility | | $14,791.08 | $24,547.09 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $25,118.86 / $34,673.69
| Facility | | $15,135.61 | $25,118.86 | $34,673.69 |