- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,431.60 / $19,659.30 / $29,933.30
| Facility | | $14,431.60 | $19,659.30 | $29,933.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,770.28 / $19,381.14 / $28,428.75
| Facility | | $12,770.28 | $19,381.14 | $28,428.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,682.84 / $19,192.56 / $34,190.00
| Facility | | $13,682.84 | $19,192.56 | $34,190.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.59 / $200.34 / $319.27
| Facility | | $136.59 | $200.34 | $319.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,070.95 / $20,857.61 / $34,326.76
| Facility | | $15,070.95 | $20,857.61 | $34,326.76 |