- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $18,197.01 / $29,512.09
| Facility | | $14,125.38 | $18,197.01 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $33,113.11 / $43,651.58
| Facility | | $22,908.68 | $33,113.11 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $26,915.35 / $37,153.52
| Facility | | $21,877.62 | $26,915.35 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $26,915.35 / $35,481.34
| Facility | | $16,218.10 | $26,915.35 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $27,542.29 / $37,153.52
| Facility | | $16,595.87 | $27,542.29 | $37,153.52 |