- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,178.97 / $10,550.60 / $16,289.10
| Facility | | $7,178.97 | $10,550.60 | $16,289.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,322.46 / $18,939.87 / $24,281.88
| Facility | | $13,322.46 | $18,939.87 | $24,281.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.85 / $13,838.64 / $19,758.11
| Facility | | $218.85 | $13,838.64 | $19,758.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,178.97 / $10,791.40 / $17,255.90
| Facility | | $7,178.97 | $10,791.40 | $17,255.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.00 / $10,920.98 / $20,741.02
| Facility | | $1,288.00 | $10,920.98 | $20,741.02 |