- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $29,512.09 / $37,153.52
| Facility | | $20,892.96 | $29,512.09 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $25,703.96 / $35,481.34
| Facility | | $16,218.10 | $25,703.96 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $30,902.95 / $42,657.95
| Facility | | $16,218.10 | $30,902.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $26,915.35 / $33,884.42
| Facility | | $16,218.10 | $26,915.35 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $30,902.95 / $42,657.95
| Facility | | $14,791.08 | $30,902.95 | $42,657.95 |