- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $29,512.09 / $38,018.94
| Facility | | $19,952.62 | $29,512.09 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $12,302.69 / $26,915.35
| Facility | | $6,606.93 | $12,302.69 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $14,125.38 / $26,302.68
| Facility | | $10,232.93 | $14,125.38 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $14,125.38 / $26,302.68
| Facility | | $10,232.93 | $14,125.38 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $18,197.01 / $28,840.32
| Facility | | $5,370.32 | $18,197.01 | $28,840.32 |