- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $18,197.01 / $28,183.83
| Facility | | $14,454.40 | $18,197.01 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $14,125.38 / $19,498.45
| Facility | | $10,715.19 | $14,125.38 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $18,197.01 / $26,915.35
| Facility | | $6,918.31 | $18,197.01 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $14,791.08 / $26,915.35
| Facility | | $10,471.29 | $14,791.08 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $12,302.69 / $21,877.62
| Facility | | $3,311.31 | $12,302.69 | $21,877.62 |