- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $21,877.62 / $25,703.96
| Facility | | $14,125.38 | $21,877.62 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $23,988.33 / $31,622.78
| Facility | | $15,848.93 | $23,988.33 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $19,054.61 / $28,183.83
| Facility | | $13,182.57 | $19,054.61 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $19,952.62 / $26,302.68
| Facility | | $14,125.38 | $19,952.62 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $20,417.38 / $33,884.42
| Facility | | $3,981.07 | $20,417.38 | $33,884.42 |