- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $28,840.32 / $45,708.82
| Facility | | $20,892.96 | $28,840.32 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,118.86 / $38,018.94
| Facility | | $16,982.44 | $25,118.86 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $30,902.95 / $45,708.82
| Facility | | $19,054.61 | $30,902.95 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $26,302.68 / $42,657.95
| Facility | | $16,595.87 | $26,302.68 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,054.61 / $32,359.37
| Facility | | $12,302.69 | $19,054.61 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $30,902.95 / $43,651.58
| Facility | | $8,709.64 | $30,902.95 | $43,651.58 |