- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $26,915.35 / $34,673.69
| Facility | | $25,118.86 | $26,915.35 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $11,481.54 / $24,547.09
| Facility | | $6,165.95 | $11,481.54 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,182.57 / $24,547.09
| Facility | | $9,549.93 | $13,182.57 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,182.57 / $24,547.09
| Facility | | $9,549.93 | $13,182.57 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $16,982.44 / $30,902.95
| Facility | | $5,370.32 | $16,982.44 | $30,902.95 |