- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $17,782.79 / $21,379.62
| Facility | | $14,791.08 | $17,782.79 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $15,848.93 / $25,703.96
| Facility | | $15,848.93 | $15,848.93 | $25,703.96 |
- 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
- $14,125.38 / $18,197.01 / $28,183.83
| Facility | | $14,125.38 | $18,197.01 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $24,547.09 / $24,547.09
| Facility | | $11,481.54 | $24,547.09 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $20,417.38 / $30,199.52
| Facility | | $14,791.08 | $20,417.38 | $30,199.52 |