- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $19,498.45 / $25,118.86
| Facility | | $13,182.57 | $19,498.45 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $8,317.64 / $17,782.79
| Facility | | $4,265.80 | $8,317.64 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $9,549.93 / $17,782.79
| Facility | | $6,918.31 | $9,549.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $9,549.93 / $17,782.79
| Facility | | $6,918.31 | $9,549.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $12,022.64 / $19,498.45
| Facility | | $5,128.61 | $12,022.64 | $19,498.45 |