- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $25,118.86 / $38,018.94
| Facility | | $18,197.01 | $25,118.86 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $22,387.21 / $32,359.37
| Facility | | $14,125.38 | $22,387.21 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $15,848.93 / $18,197.01
| Facility | | $13,489.63 | $15,848.93 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $245.47 / $371.54
| Facility | | $151.36 | $245.47 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $24,547.09 / $36,307.81
| Facility | | $15,848.93 | $24,547.09 | $36,307.81 |