- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $28,840.32 / $43,651.58
| Facility | | $20,892.96 | $28,840.32 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $25,703.96 / $37,153.52
| Facility | | $16,218.10 | $25,703.96 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $25,118.86 / $44,668.36
| Facility | | $17,782.79 | $25,118.86 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $281.84 / $426.58
| Facility | | $177.83 | $281.84 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $27,542.29 / $40,738.03
| Facility | | $18,197.01 | $27,542.29 | $40,738.03 |