- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $7,079.46 / $20,417.38
| Facility | | $3,548.13 | $7,079.46 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $17,378.01 / $31,622.78
| Facility | | $8,912.51 | $17,378.01 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $23,442.29
| Facility | | $1,174.90 | $1,174.90 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $16,595.87 / $16,982.44
| Facility | | $16,595.87 | $16,595.87 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,220.18 / $18,620.87
| Facility | | $7,244.36 | $11,220.18 | $18,620.87 |