- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,503.90 / $21,063.40 / $29,588.40
| Facility | | $15,503.90 | $21,063.40 | $29,588.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,620.92 / $19,154.46 / $28,096.25
| Facility | | $12,620.92 | $19,154.46 | $28,096.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,525.16 / $18,672.29 / $33,796.00
| Facility | | $13,525.16 | $18,672.29 | $33,796.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.02 / $192.76 / $315.60
| Facility | | $135.02 | $192.76 | $315.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,530.95 / $21,411.46 / $31,567.15
| Facility | | $15,530.95 | $21,411.46 | $31,567.15 |