- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,821.40 / $21,494.60 / $30,194.20
| Facility | | $15,821.40 | $21,494.60 | $30,194.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,517.48 / $19,358.79 / $28,583.92
| Facility | | $12,517.48 | $19,358.79 | $28,583.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,802.10 / $19,054.62 / $34,488.00
| Facility | | $13,802.10 | $19,054.62 | $34,488.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.78 / $196.70 / $322.07
| Facility | | $137.78 | $196.70 | $322.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,202.31 / $21,039.40 / $34,625.94
| Facility | | $15,202.31 | $21,039.40 | $34,625.94 |