- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $21,877.62 / $26,302.68
| Facility | | $18,197.01 | $21,877.62 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $19,952.62 / $31,622.78
| Facility | | $19,498.45 | $19,952.62 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $22,387.21 / $35,481.34
| Facility | | $17,378.01 | $22,387.21 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $29,512.09 / $29,512.09
| Facility | | $14,125.38 | $29,512.09 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $25,118.86 / $37,153.52
| Facility | | $18,197.01 | $25,118.86 | $37,153.52 |