- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,901.70 / $21,760.90 / $28,601.30
| Facility | | $14,901.70 | $21,760.90 | $28,601.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,695.21 / $15,510.19 / $26,233.40
| Facility | | $5,695.21 | $15,510.19 | $26,233.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,684.72 / $21,958.34 / $39,167.48
| Facility | | $15,684.72 | $21,958.34 | $39,167.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,744.30 / $24,393.38 / $35,616.33
| Facility | | $18,744.30 | $24,393.38 | $35,616.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,744.30 / $22,676.90 / $35,616.33
| Facility | | $18,744.30 | $22,676.90 | $35,616.33 |