- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,952.62 / $30,199.52
| Facility | | $14,454.40 | $19,952.62 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $17,782.79 / $25,703.96
| Facility | | $11,220.18 | $17,782.79 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $17,378.01 / $30,902.95
| Facility | | $12,302.69 | $17,378.01 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $194.98 / $288.40
| Facility | | $128.82 | $194.98 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,054.61 / $28,183.83
| Facility | | $12,589.25 | $19,054.61 | $28,183.83 |