- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,199.70 / $19,275.50 / $25,334.70
| Facility | | $13,199.70 | $19,275.50 | $25,334.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,506.60 / $6,826.43 / $11,545.98
| Facility | | $2,506.60 | $6,826.43 | $11,545.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,409.11 / $19,361.18 / $32,406.24
| Facility | | $13,409.11 | $19,361.18 | $32,406.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,603.45 / $21,607.33 / $31,548.46
| Facility | | $16,603.45 | $21,607.33 | $31,548.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,603.45 / $20,086.89 / $31,548.46
| Facility | | $16,603.45 | $20,086.89 | $31,548.46 |