- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $16,595.87 / $21,379.62
| Facility | | $11,220.18 | $16,595.87 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $7,079.46 / $15,135.61
| Facility | | $3,801.89 | $7,079.46 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,128.31 / $15,135.61
| Facility | | $5,888.44 | $8,128.31 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,128.31 / $15,135.61
| Facility | | $5,888.44 | $8,128.31 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $10,471.29 / $21,379.62
| Facility | | $4,365.16 | $10,471.29 | $21,379.62 |