- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $21,379.62 / $26,302.68
| Facility | | $17,782.79 | $21,379.62 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $19,498.45 / $30,902.95
| Facility | | $19,054.61 | $19,498.45 | $30,902.95 |
- 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
- $16,982.44 / $21,877.62 / $34,673.69
| Facility | | $16,982.44 | $21,877.62 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $29,512.09 / $29,512.09
| Facility | | $13,182.57 | $29,512.09 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $24,547.09 / $37,153.52
| Facility | | $17,782.79 | $24,547.09 | $37,153.52 |