- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $14,454.40 / $16,595.87
| Facility | | $11,220.18 | $14,454.40 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $10,471.29 / $17,782.79
| Facility | | $3,162.28 | $10,471.29 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $13,182.57 / $15,848.93
| Facility | | $11,220.18 | $13,182.57 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $16,595.87 / $20,417.38
| Facility | | $10,232.93 | $16,595.87 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $12,589.25 / $20,417.38
| Facility | | $3,630.78 | $12,589.25 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $15,135.61 / $19,498.45
| Facility | | $1,513.56 | $15,135.61 | $19,498.45 |