- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $16,982.44 / $24,547.09
| Facility | | $14,125.38 | $16,982.44 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $26,915.35 / $36,307.81
| Facility | | $19,054.61 | $26,915.35 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $22,387.21 / $30,902.95
| Facility | | $18,197.01 | $22,387.21 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $22,387.21 / $29,512.09
| Facility | | $13,489.63 | $22,387.21 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $22,908.68 / $30,902.95
| Facility | | $13,803.84 | $22,908.68 | $30,902.95 |