- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,235.10 / $20,698.09 / $29,075.40
| Facility | | $15,235.10 | $20,698.09 | $29,075.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,404.34 / $18,825.77 / $27,614.12
| Facility | | $12,404.34 | $18,825.77 | $27,614.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,290.64 / $18,348.53 / $33,210.00
| Facility | | $13,290.64 | $18,348.53 | $33,210.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.66 / $189.41 / $310.13
| Facility | | $132.66 | $189.41 | $310.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,261.66 / $21,040.20 / $31,019.80
| Facility | | $15,261.66 | $21,040.20 | $31,019.80 |