- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $19,054.61 / $22,908.68
| Facility | | $15,848.93 | $19,054.61 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $16,982.44 / $27,542.29
| Facility | | $16,595.87 | $16,982.44 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $19,498.45 / $30,199.52
| Facility | | $15,135.61 | $19,498.45 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $25,118.86 / $25,118.86
| Facility | | $11,748.98 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $21,877.62 / $32,359.37
| Facility | | $15,488.17 | $21,877.62 | $32,359.37 |