- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $26,302.68 / $33,884.42
| Facility | | $18,197.01 | $26,302.68 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $11,220.18 / $23,988.33
| Facility | | $5,754.40 | $11,220.18 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $12,882.50 / $23,988.33
| Facility | | $9,332.54 | $12,882.50 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $12,882.50 / $23,988.33
| Facility | | $9,332.54 | $12,882.50 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $16,595.87 / $26,302.68
| Facility | | $5,370.32 | $16,595.87 | $26,302.68 |