- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,530.40 / $19,758.30 / $25,969.30
| Facility | | $13,530.40 | $19,758.30 | $25,969.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,064.98 / $46,474.37 / $78,605.13
| Facility | | $17,064.98 | $46,474.37 | $78,605.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,744.98 / $19,846.14 / $35,563.06
| Facility | | $13,744.98 | $19,846.14 | $35,563.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,019.34 / $22,148.56 / $32,338.70
| Facility | | $17,019.34 | $22,148.56 | $32,338.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,019.34 / $20,590.04 / $32,338.70
| Facility | | $17,019.34 | $20,590.04 | $32,338.70 |