- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,710.10 / $20,020.80 / $26,314.20
| Facility | | $13,710.10 | $20,020.80 | $26,314.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,563.85 / $12,429.10 / $21,022.15
| Facility | | $4,563.85 | $12,429.10 | $21,022.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,430.50 / $20,202.46 / $36,684.23
| Facility | | $14,430.50 | $20,202.46 | $36,684.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,245.43 / $22,442.78 / $32,768.29
| Facility | | $17,245.43 | $22,442.78 | $32,768.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,245.43 / $20,863.56 / $32,768.29
| Facility | | $17,245.43 | $20,863.56 | $32,768.29 |