- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,229.70 / $22,049.30 / $34,718.19
| Facility | | $16,229.70 | $22,049.30 | $34,718.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,210.89 / $19,864.09 / $29,409.62
| Facility | | $13,210.89 | $19,864.09 | $29,409.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,636.45 / $19,218.00 / $35,112.67
| Facility | | $13,636.45 | $19,218.00 | $35,112.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.00 / $178.55 / $284.56
| Facility | | $125.00 | $178.55 | $284.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,594.62 / $21,582.35 / $35,519.51
| Facility | | $15,594.62 | $21,582.35 | $35,519.51 |