- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,564.40 / $21,268.40 / $27,953.90
| Facility | | $14,564.40 | $21,268.40 | $27,953.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,562.96 / $20,764.49 / $34,836.71
| Facility | | $7,562.96 | $20,764.49 | $34,836.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,329.71 / $21,461.33 / $38,280.96
| Facility | | $15,329.71 | $21,461.33 | $38,280.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,320.04 / $23,841.26 / $34,810.18
| Facility | | $18,320.04 | $23,841.26 | $34,810.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,320.04 / $22,163.63 / $34,810.18
| Facility | | $18,320.04 | $22,163.63 | $34,810.18 |