- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $23,442.29 / $27,542.29
| Facility | | $15,135.61 | $23,442.29 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,118.86 / $33,884.42
| Facility | | $16,982.44 | $25,118.86 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $20,417.38 / $30,199.52
| Facility | | $13,803.84 | $20,417.38 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $20,417.38 / $27,542.29
| Facility | | $14,125.38 | $20,417.38 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $11,748.98 / $35,481.34
| Facility | | $4,466.84 | $11,748.98 | $35,481.34 |