- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $23,988.33 / $30,902.95
| Facility | | $16,982.44 | $23,988.33 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $21,379.62 / $29,512.09
| Facility | | $11,748.98 | $21,379.62 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $25,118.86 / $35,481.34
| Facility | | $13,182.57 | $25,118.86 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $21,379.62 / $25,703.96
| Facility | | $11,748.98 | $21,379.62 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $25,118.86 / $35,481.34
| Facility | | $12,302.69 | $25,118.86 | $35,481.34 |