- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $15,848.93 / $22,908.68
| Facility | | $13,182.57 | $15,848.93 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $25,118.86 / $33,884.42
| Facility | | $17,782.79 | $25,118.86 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $20,417.38 / $28,840.32
| Facility | | $16,595.87 | $20,417.38 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $20,417.38 / $27,542.29
| Facility | | $12,302.69 | $20,417.38 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,054.61 / $28,840.32
| Facility | | $12,302.69 | $19,054.61 | $28,840.32 |