- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $25,703.96 / $37,153.52
| Facility | | $17,782.79 | $25,703.96 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $19,952.62 / $30,902.95
| Facility | | $13,803.84 | $19,952.62 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $25,118.86 / $33,884.42
| Facility | | $17,378.01 | $25,118.86 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $12,589.25
| Facility | | $12,589.25 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $21,877.62 / $29,512.09
| Facility | | $10,964.78 | $21,877.62 | $29,512.09 |