- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $14,454.40 / $19,054.61
| Facility | | $8,912.51 | $14,454.40 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $22,908.68 / $28,183.83
| Facility | | $15,848.93 | $22,908.68 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $17,378.01 / $17,378.01
| Facility | | $17,378.01 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $13,803.84 / $18,620.87
| Facility | | $9,332.54 | $13,803.84 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $17,378.01 / $17,378.01
| Facility | | $17,378.01 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,589.25 / $19,952.62
| Facility | | $8,128.31 | $12,589.25 | $19,952.62 |