- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,664.60 / $21,248.20 / $30,416.60
| Facility | | $14,664.60 | $21,248.20 | $30,416.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,611.87 / $19,531.78 / $28,799.46
| Facility | | $12,611.87 | $19,531.78 | $28,799.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,903.75 / $19,194.96 / $34,742.00
| Facility | | $13,903.75 | $19,194.96 | $34,742.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.79 / $198.15 / $324.44
| Facility | | $138.79 | $198.15 | $324.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,314.27 / $21,194.36 / $34,880.97
| Facility | | $15,314.27 | $21,194.36 | $34,880.97 |