- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $28,183.83 / $42,657.95
| Facility | | $20,417.38 | $28,183.83 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $25,118.86 / $36,307.81
| Facility | | $15,848.93 | $25,118.86 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $24,547.09 / $43,651.58
| Facility | | $17,378.01 | $24,547.09 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $275.42 / $407.38
| Facility | | $173.78 | $275.42 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $26,915.35 / $39,810.72
| Facility | | $17,378.01 | $26,915.35 | $39,810.72 |