- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $26,915.35 / $38,018.94
| Facility | | $17,782.79 | $26,915.35 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $15,848.93 / $26,302.68
| Facility | | $5,888.44 | $15,848.93 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $21,877.62 / $36,307.81
| Facility | | $15,848.93 | $21,877.62 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $24,547.09 / $35,481.34
| Facility | | $19,498.45 | $24,547.09 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $23,442.29 / $34,673.69
| Facility | | $12,302.69 | $23,442.29 | $34,673.69 |