- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,976.70 / $18,949.90 / $24,906.60
| Facility | | $12,976.70 | $18,949.90 | $24,906.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,073.29 / $21,986.61 / $37,187.39
| Facility | | $8,073.29 | $21,986.61 | $37,187.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,658.59 / $19,121.79 / $34,107.87
| Facility | | $13,658.59 | $19,121.79 | $34,107.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,322.94 / $21,242.28 / $31,015.45
| Facility | | $16,322.94 | $21,242.28 | $31,015.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,322.94 / $19,747.53 / $31,015.45
| Facility | | $16,322.94 | $19,747.53 | $31,015.45 |