- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $15,848.93 / $33,884.42
| Facility | | $7,413.10 | $15,848.93 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $28,183.83 / $35,481.34
| Facility | | $19,054.61 | $28,183.83 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $20,892.96 / $28,840.32
| Facility | | $15,488.17 | $20,892.96 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $21,379.62 / $53,703.18
| Facility | | $12,022.64 | $21,379.62 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $16,595.87 / $28,840.32
| Facility | | $6,309.57 | $16,595.87 | $28,840.32 |