- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $22,387.21 / $26,915.35
| Facility | | $18,620.87 | $22,387.21 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $20,417.38 / $32,359.37
| Facility | | $19,952.62 | $20,417.38 | $32,359.37 |
- 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
- $17,782.79 / $22,908.68 / $36,307.81
| Facility | | $17,782.79 | $22,908.68 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $30,902.95 / $30,902.95
| Facility | | $15,135.61 | $30,902.95 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $25,703.96 / $38,018.94
| Facility | | $18,620.87 | $25,703.96 | $38,018.94 |