- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,494.90 / $25,573.40 / $35,945.60
| Facility | | $16,494.90 | $25,573.40 | $35,945.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,759.15 / $22,604.75 / $28,971.82
| Facility | | $16,759.15 | $22,604.75 | $28,971.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,874.81 / $23,834.78 / $36,110.19
| Facility | | $14,874.81 | $23,834.78 | $36,110.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,516.00 / $24,019.37 / $37,206.07
| Facility | | $15,516.00 | $24,019.37 | $37,206.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,121.54 / $23,268.26 / $35,209.81
| Facility | | $14,121.54 | $23,268.26 | $35,209.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $28,016.10 / $39,954.60
| Facility | | $10,403.00 | $28,016.10 | $39,954.60 |