- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,731.60 / $19,804.80 / $34,850.69
| Facility | | $11,731.60 | $19,804.80 | $34,850.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,936.25 / $24,061.22 / $39,783.89
| Facility | | $16,936.25 | $24,061.22 | $39,783.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,671.69 / $18,228.09 / $25,207.15
| Facility | | $10,671.69 | $18,228.09 | $25,207.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,227.19 / $37,227.19 / $43,689.28
| Facility | | $37,227.19 | $37,227.19 | $43,689.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $17,259.72 / $24,653.54
| Facility | | $1,787.00 | $17,259.72 | $24,653.54 |