- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,276.30 / $19,387.30 / $25,481.60
| Facility | | $13,276.30 | $19,387.30 | $25,481.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,339.64 / $11,818.50 / $19,989.41
| Facility | | $4,339.64 | $11,818.50 | $19,989.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,486.88 / $19,473.47 / $32,594.19
| Facility | | $13,486.88 | $19,473.47 | $32,594.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,699.75 / $21,732.65 / $31,731.44
| Facility | | $16,699.75 | $21,732.65 | $31,731.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,699.75 / $20,203.39 / $31,731.44
| Facility | | $16,699.75 | $20,203.39 | $31,731.44 |