- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $22,387.21 / $33,884.42
| Facility | | $15,848.93 | $22,387.21 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $19,952.62 / $29,512.09
| Facility | | $12,882.50 | $19,952.62 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $19,498.45 / $34,673.69
| Facility | | $14,125.38 | $19,498.45 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $218.78 / $331.13
| Facility | | $147.91 | $218.78 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $21,877.62 / $31,622.78
| Facility | | $14,125.38 | $21,877.62 | $31,622.78 |