- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,848.93 / $20,417.38
| Facility | | $10,715.19 | $15,848.93 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $6,760.83 / $14,454.40
| Facility | | $3,630.78 | $6,760.83 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $7,585.78 / $14,125.38
| Facility | | $5,495.41 | $7,585.78 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $7,585.78 / $14,125.38
| Facility | | $5,495.41 | $7,585.78 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $9,772.37 / $15,488.17
| Facility | | $4,073.80 | $9,772.37 | $15,488.17 |