- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $21,877.62 / $28,183.83
| Facility | | $18,620.87 | $21,877.62 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $22,387.21 / $38,904.51
| Facility | | $9,549.93 | $22,387.21 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $26,302.68 / $36,307.81
| Facility | | $19,952.62 | $26,302.68 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $25,118.86 / $39,810.72
| Facility | | $12,022.64 | $25,118.86 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $22,387.21 / $33,884.42
| Facility | | $14,125.38 | $22,387.21 | $33,884.42 |