- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $21,379.62 / $30,902.95
| Facility | | $14,454.40 | $21,379.62 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $20,417.38 / $40,738.03
| Facility | | $16,218.10 | $20,417.38 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $19,054.61 / $29,512.09
| Facility | | $10,964.78 | $19,054.61 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $24,547.09 / $34,673.69
| Facility | | $15,135.61 | $24,547.09 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $22,908.68 / $34,673.69
| Facility | | $13,182.57 | $22,908.68 | $34,673.69 |