- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,622.68 / $25,752.90 / $42,756.00
| Facility | | $18,622.68 | $25,752.90 | $42,756.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,929.03 / $23,862.63 / $40,423.79
| Facility | | $15,929.03 | $23,862.63 | $40,423.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,198.23 / $27,468.48 / $39,496.33
| Facility | | $22,198.23 | $27,468.48 | $39,496.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,271.69 / $26,989.37 / $44,206.57
| Facility | | $13,271.69 | $26,989.37 | $44,206.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,271.69 / $26,329.21 / $37,004.40
| Facility | | $13,271.69 | $26,329.21 | $37,004.40 |