- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $26,302.68 / $53,703.18
| Facility | | $22,387.21 | $26,302.68 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $19,498.45 / $29,512.09
| Facility | | $16,595.87 | $19,498.45 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $14,791.08 / $19,054.61
| Facility | | $12,882.50 | $14,791.08 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $19,054.61 / $28,183.83
| Facility | | $16,595.87 | $19,054.61 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $18,197.01 / $18,620.87
| Facility | | $14,791.08 | $18,197.01 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $21,379.62 / $26,302.68
| Facility | | $16,595.87 | $21,379.62 | $26,302.68 |