- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $15,135.61 / $30,902.95
| Facility | | $7,079.46 | $15,135.61 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $15,135.61 / $26,302.68
| Facility | | $7,244.36 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $8,128.31 / $16,595.87
| Facility | | $5,248.07 | $8,128.31 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $20,417.38 / $26,302.68
| Facility | | $14,791.08 | $20,417.38 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $13,182.57 / $30,902.95
| Facility | | $5,370.32 | $13,182.57 | $30,902.95 |