- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $25,118.86 / $47,863.01
| Facility | | $16,218.10 | $25,118.86 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $18,620.87 / $28,183.83
| Facility | | $16,218.10 | $18,620.87 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $21,379.62 / $34,673.69
| Facility | | $14,125.38 | $21,379.62 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $25,703.96 / $53,703.18
| Facility | | $12,882.50 | $25,703.96 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $22,387.21 / $31,622.78
| Facility | | $6,456.54 | $22,387.21 | $31,622.78 |