- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $27,542.29 / $41,686.94
| Facility | | $19,952.62 | $27,542.29 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $23,988.33 / $35,481.34
| Facility | | $15,135.61 | $23,988.33 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $23,988.33 / $42,657.95
| Facility | | $16,982.44 | $23,988.33 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $269.15 / $398.11
| Facility | | $169.82 | $269.15 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $26,302.68 / $38,904.51
| Facility | | $16,982.44 | $26,302.68 | $38,904.51 |