- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,611.40 / $24,257.60 / $31,882.90
| Facility | | $16,611.40 | $24,257.60 | $31,882.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,351.60 / $38,705.22 / $65,464.67
| Facility | | $14,351.60 | $38,705.22 | $65,464.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,484.30 / $24,477.72 / $43,661.35
| Facility | | $17,484.30 | $24,477.72 | $43,661.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,894.91 / $27,192.15 / $39,702.75
| Facility | | $20,894.91 | $27,192.15 | $39,702.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,894.91 / $25,278.72 / $39,702.75
| Facility | | $20,894.91 | $25,278.72 | $39,702.75 |