- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $18,620.87 / $22,387.21
| Facility | | $15,488.17 | $18,620.87 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $16,595.87 / $26,915.35
| Facility | | $16,595.87 | $16,595.87 | $26,915.35 |
- 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
- $14,791.08 / $19,054.61 / $29,512.09
| Facility | | $14,791.08 | $19,054.61 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $25,703.96 / $25,703.96
| Facility | | $12,022.64 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $19,498.45 / $31,622.78
| Facility | | $15,488.17 | $19,498.45 | $31,622.78 |