- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,690.50 / $18,531.80 / $24,357.20
| Facility | | $12,690.50 | $18,531.80 | $24,357.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,751.47 / $12,940.06 / $21,886.37
| Facility | | $4,751.47 | $12,940.06 | $21,886.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,891.77 / $18,614.20 / $31,155.97
| Facility | | $12,891.77 | $18,614.20 | $31,155.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,962.87 / $20,773.70 / $30,331.29
| Facility | | $15,962.87 | $20,773.70 | $30,331.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,962.87 / $19,311.91 / $30,331.29
| Facility | | $15,962.87 | $19,311.91 | $30,331.29 |