- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $26,915.35 / $38,018.94
| Facility | | $17,782.79 | $26,915.35 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $23,442.29 / $38,904.51
| Facility | | $8,709.64 | $23,442.29 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $22,387.21 / $38,018.94
| Facility | | $15,848.93 | $22,387.21 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $24,547.09 / $36,307.81
| Facility | | $19,952.62 | $24,547.09 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $23,988.33 / $34,673.69
| Facility | | $12,589.25 | $23,988.33 | $34,673.69 |