- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,889.80 / $20,283.30 / $26,659.20
| Facility | | $13,889.80 | $20,283.30 | $26,659.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,905.37 / $24,252.72 / $41,020.19
| Facility | | $8,905.37 | $24,252.72 | $41,020.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,619.69 / $20,467.31 / $36,507.91
| Facility | | $14,619.69 | $20,467.31 | $36,507.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,471.52 / $22,737.01 / $33,197.87
| Facility | | $17,471.52 | $22,737.01 | $33,197.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,471.52 / $21,137.08 / $33,197.87
| Facility | | $17,471.52 | $21,137.08 | $33,197.87 |