- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $19,498.45 / $23,442.29
| Facility | | $16,218.10 | $19,498.45 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $17,782.79 / $28,183.83
| Facility | | $17,378.01 | $17,782.79 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $19,952.62 / $31,622.78
| Facility | | $15,488.17 | $19,952.62 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $24,547.09 / $24,547.09
| Facility | | $10,471.29 | $24,547.09 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $22,387.21 / $33,113.11
| Facility | | $16,218.10 | $22,387.21 | $33,113.11 |