- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $17,782.79 / $25,118.86
| Facility | | $11,748.98 | $17,782.79 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $11,748.98 / $19,498.45
| Facility | | $4,365.16 | $11,748.98 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $14,791.08 / $25,118.86
| Facility | | $10,471.29 | $14,791.08 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $16,218.10 / $23,442.29
| Facility | | $12,882.50 | $16,218.10 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $15,488.17 / $22,908.68
| Facility | | $8,128.31 | $15,488.17 | $22,908.68 |