- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,488.17 / $23,988.33
| Facility | | $10,964.78 | $15,488.17 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $13,182.57 / $18,197.01
| Facility | | $7,585.78 | $13,182.57 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $18,620.87 / $26,915.35
| Facility | | $16,982.44 | $18,620.87 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $17,378.01 / $23,988.33
| Facility | | $15,848.93 | $17,378.01 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,232.93 / $13,182.57
| Facility | | $6,456.54 | $10,232.93 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $16,982.44 / $23,442.29
| Facility | | $7,413.10 | $16,982.44 | $23,442.29 |