- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $29,512.09 / $33,884.42
| Facility | | $21,379.62 | $29,512.09 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $19,498.45 / $19,952.62
| Facility | | $19,498.45 | $19,498.45 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $28,183.83 / $36,307.81
| Facility | | $15,488.17 | $28,183.83 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $21,379.62 / $52,480.75
| Facility | | $14,125.38 | $21,379.62 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $20,892.96 / $30,902.95
| Facility | | $13,182.57 | $20,892.96 | $30,902.95 |