- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $26,302.68 / $39,810.72
| Facility | | $19,054.61 | $26,302.68 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $23,442.29 / $33,884.42
| Facility | | $14,454.40 | $23,442.29 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $22,908.68 / $40,738.03
| Facility | | $16,218.10 | $22,908.68 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $257.04 / $380.19
| Facility | | $162.18 | $257.04 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $25,118.86 / $37,153.52
| Facility | | $16,218.10 | $25,118.86 | $37,153.52 |