- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $19,952.62 / $25,703.96
| Facility | | $13,489.63 | $19,952.62 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,511.38 / $18,197.01
| Facility | | $4,570.88 | $8,511.38 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $9,549.93 / $17,782.79
| Facility | | $6,918.31 | $9,549.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $9,549.93 / $17,782.79
| Facility | | $6,918.31 | $9,549.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $12,302.69 / $19,498.45
| Facility | | $5,248.07 | $12,302.69 | $19,498.45 |