- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,337.80 / $19,143.09 / $30,671.10
| Facility | | $14,337.80 | $19,143.09 | $30,671.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,672.48 / $17,715.04 / $26,081.78
| Facility | | $11,672.48 | $17,715.04 | $26,081.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,507.85 / $17,544.43 / $31,254.00
| Facility | | $12,507.85 | $17,544.43 | $31,254.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.00 / $183.13 / $291.87
| Facility | | $125.00 | $183.13 | $291.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,776.76 / $19,066.50 / $31,379.02
| Facility | | $13,776.76 | $19,066.50 | $31,379.02 |