- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,926.70 / $18,621.50 / $29,320.80
| Facility | | $12,926.70 | $18,621.50 | $29,320.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,847.51 / $16,962.16 / $24,770.52
| Facility | | $10,847.51 | $16,962.16 | $24,770.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,891.44 / $15,938.42 / $29,878.00
| Facility | | $11,891.44 | $15,938.42 | $29,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.00 / $175.07 / $279.02
| Facility | | $125.00 | $175.07 | $279.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,716.66 / $17,926.80 / $28,895.01
| Facility | | $11,716.66 | $17,926.80 | $28,895.01 |