- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $33,113.11 / $42,657.95
| Facility | | $22,908.68 | $33,113.11 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $14,125.38 / $30,199.52
| Facility | | $7,413.10 | $14,125.38 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,218.10 / $30,199.52
| Facility | | $11,748.98 | $16,218.10 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,218.10 / $30,199.52
| Facility | | $11,748.98 | $16,218.10 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $20,892.96 / $33,113.11
| Facility | | $5,370.32 | $20,892.96 | $33,113.11 |