- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,969.40 / $21,859.70 / $28,731.20
| Facility | | $14,969.40 | $21,859.70 | $28,731.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,423.17 / $17,492.72 / $29,586.57
| Facility | | $6,423.17 | $17,492.72 | $29,586.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,755.96 / $22,058.07 / $39,345.37
| Facility | | $15,755.96 | $22,058.07 | $39,345.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,829.43 / $24,504.17 / $35,778.08
| Facility | | $18,829.43 | $24,504.17 | $35,778.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,829.43 / $22,779.89 / $35,778.08
| Facility | | $18,829.43 | $22,779.89 | $35,778.08 |