- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,718.20 / $18,572.40 / $24,410.50
| Facility | | $12,718.20 | $18,572.40 | $24,410.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,172.26 / $13,949.21 / $23,593.21
| Facility | | $5,172.26 | $13,949.21 | $23,593.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,386.49 / $18,740.86 / $33,428.40
| Facility | | $13,386.49 | $18,740.86 | $33,428.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,997.76 / $20,819.09 / $30,397.58
| Facility | | $15,997.76 | $20,819.09 | $30,397.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,997.76 / $19,354.13 / $30,397.58
| Facility | | $15,997.76 | $19,354.13 | $30,397.58 |