- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $22,387.21 / $38,904.51
| Facility | | $16,218.10 | $22,387.21 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,952.62 / $28,840.32
| Facility | | $12,589.25 | $19,952.62 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $19,498.45 / $34,673.69
| Facility | | $13,803.84 | $19,498.45 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $218.78 / $323.59
| Facility | | $144.54 | $218.78 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $21,379.62 / $31,622.78
| Facility | | $14,125.38 | $21,379.62 | $31,622.78 |