- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,746.85 / $19,999.70 / $32,202.10
| Facility | | $8,746.85 | $19,999.70 | $32,202.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $10,996.91 / $27,538.80
| Facility | | $1,474.01 | $10,996.91 | $27,538.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,477.21 / $20,910.97 / $29,622.90
| Facility | | $14,477.21 | $20,910.97 | $29,622.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,654.67 / $17,538.61 / $40,802.00
| Facility | | $12,654.67 | $17,538.61 | $40,802.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,654.67 / $21,398.20 / $37,939.06
| Facility | | $12,654.67 | $21,398.20 | $37,939.06 |