- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $20,892.96 / $25,118.86
| Facility | | $17,378.01 | $20,892.96 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $19,054.61 / $30,199.52
| Facility | | $18,620.87 | $19,054.61 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $21,379.62 / $33,884.42
| Facility | | $16,595.87 | $21,379.62 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $34,673.69 / $34,673.69
| Facility | | $14,791.08 | $34,673.69 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $23,988.33 / $35,481.34
| Facility | | $17,378.01 | $23,988.33 | $35,481.34 |