- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $31,622.78 / $40,738.03
| Facility | | $21,877.62 | $31,622.78 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $13,489.63 / $28,840.32
| Facility | | $6,918.31 | $13,489.63 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $15,488.17 / $28,840.32
| Facility | | $11,220.18 | $15,488.17 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $15,488.17 / $28,840.32
| Facility | | $11,220.18 | $15,488.17 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $19,952.62 / $31,622.78
| Facility | | $5,370.32 | $19,952.62 | $31,622.78 |