- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $26,915.35 / $34,673.69
| Facility | | $18,197.01 | $26,915.35 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $11,481.54 / $24,547.09
| Facility | | $5,888.44 | $11,481.54 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,182.57 / $24,547.09
| Facility | | $9,549.93 | $13,182.57 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,182.57 / $24,547.09
| Facility | | $9,549.93 | $13,182.57 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $16,595.87 / $26,915.35
| Facility | | $5,370.32 | $16,595.87 | $26,915.35 |