- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,153.60 / $22,128.70 / $29,084.70
| Facility | | $15,153.60 | $22,128.70 | $29,084.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,790.89 / $15,770.78 / $26,674.15
| Facility | | $5,790.89 | $15,770.78 | $26,674.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,282.17 / $21,234.09 / $37,203.03
| Facility | | $14,282.17 | $21,234.09 | $37,203.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,061.09 / $24,805.66 / $36,218.28
| Facility | | $19,061.09 | $24,805.66 | $36,218.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,061.09 / $23,060.17 / $36,218.28
| Facility | | $19,061.09 | $23,060.17 | $36,218.28 |