- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $17,782.79 / $26,302.68
| Facility | | $15,135.61 | $17,782.79 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $28,840.32 / $38,904.51
| Facility | | $20,417.38 | $28,840.32 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $23,988.33 / $33,113.11
| Facility | | $19,498.45 | $23,988.33 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $23,988.33 / $31,622.78
| Facility | | $14,454.40 | $23,988.33 | $31,622.78 |
- 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 |