- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,861.30 / $18,781.40 / $24,685.20
| Facility | | $12,861.30 | $18,781.40 | $24,685.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,493.74 / $17,724.97 / $29,621.14
| Facility | | $6,493.74 | $17,724.97 | $29,621.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,537.14 / $18,951.75 / $33,804.58
| Facility | | $13,537.14 | $18,951.75 | $33,804.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,177.80 / $21,053.39 / $30,739.67
| Facility | | $16,177.80 | $21,053.39 | $30,739.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,177.80 / $19,571.93 / $30,739.67
| Facility | | $16,177.80 | $19,571.93 | $30,739.67 |