- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $22,387.21 / $26,302.68
| Facility | | $14,454.40 | $22,387.21 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $23,988.33 / $32,359.37
| Facility | | $16,218.10 | $23,988.33 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $19,498.45 / $28,840.32
| Facility | | $13,489.63 | $19,498.45 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $19,952.62 / $26,915.35
| Facility | | $14,125.38 | $19,952.62 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $23,442.29 / $34,673.69
| Facility | | $4,073.80 | $23,442.29 | $34,673.69 |