- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,118.86 / $32,359.37
| Facility | | $16,982.44 | $25,118.86 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $10,471.29 / $22,908.68
| Facility | | $5,495.41 | $10,471.29 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $12,022.64 / $22,387.21
| Facility | | $8,709.64 | $12,022.64 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $12,022.64 / $22,387.21
| Facility | | $8,709.64 | $12,022.64 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $15,488.17 / $24,547.09
| Facility | | $5,370.32 | $15,488.17 | $24,547.09 |