- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $22,387.21 / $31,622.78
| Facility | | $13,803.84 | $22,387.21 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,512.09 / $29,512.09 / $29,512.09
| Facility | | $29,512.09 | $29,512.09 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $26,302.68 / $35,481.34
| Facility | | $16,982.44 | $26,302.68 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $22,387.21 / $36,307.81
| Facility | | $14,125.38 | $22,387.21 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $19,952.62 / $38,904.51
| Facility | | $4,073.80 | $19,952.62 | $38,904.51 |