- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,952.62 / $30,199.52
| Facility | | $14,454.40 | $19,952.62 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $17,782.79 / $26,302.68
| Facility | | $11,481.54 | $17,782.79 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $17,378.01 / $30,902.95
| Facility | | $12,589.25 | $17,378.01 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $194.98 / $295.12
| Facility | | $131.83 | $194.98 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $19,498.45 / $28,183.83
| Facility | | $12,882.50 | $19,498.45 | $28,183.83 |