- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $18,620.87 / $23,988.33
| Facility | | $12,589.25 | $18,620.87 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $7,762.47 / $16,982.44
| Facility | | $4,168.69 | $7,762.47 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $8,912.51 / $16,595.87
| Facility | | $6,456.54 | $8,912.51 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $8,912.51 / $16,595.87
| Facility | | $6,456.54 | $8,912.51 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $11,481.54 / $18,197.01
| Facility | | $4,786.30 | $11,481.54 | $18,197.01 |