- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,118.86 / $42,657.95
| Facility | | $16,982.44 | $25,118.86 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,952.62 / $33,113.11
| Facility | | $14,454.40 | $19,952.62 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $15,848.93 / $20,892.96
| Facility | | $11,748.98 | $15,848.93 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $21,877.62 / $31,622.78
| Facility | | $13,803.84 | $21,877.62 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $20,417.38 / $27,542.29
| Facility | | $15,135.61 | $20,417.38 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $22,908.68 / $31,622.78
| Facility | | $7,762.47 | $22,908.68 | $31,622.78 |