- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,540.50 / $18,395.80 / $25,841.30
| Facility | | $13,540.50 | $18,395.80 | $25,841.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,716.82 / $16,770.93 / $24,472.08
| Facility | | $10,716.82 | $16,770.93 | $24,472.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,812.30 / $16,307.59 / $29,516.00
| Facility | | $11,812.30 | $16,307.59 | $29,516.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.66 / $172.95 / $275.64
| Facility | | $123.66 | $172.95 | $275.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,010.65 / $18,006.24 / $29,634.06
| Facility | | $13,010.65 | $18,006.24 | $29,634.06 |