- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $17,782.79 / $22,908.68
| Facility | | $12,022.64 | $17,782.79 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $7,413.10 / $16,218.10
| Facility | | $3,801.89 | $7,413.10 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,511.38 / $15,848.93
| Facility | | $6,165.95 | $8,511.38 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,511.38 / $15,848.93
| Facility | | $6,165.95 | $8,511.38 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $10,964.78 / $17,378.01
| Facility | | $4,570.88 | $10,964.78 | $17,378.01 |