- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,438.62 / $19,294.90 / $31,067.30
| Facility | | $8,438.62 | $19,294.90 | $31,067.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,821.09 / $10,821.09 / $14,061.87
| Facility | | $10,821.09 | $10,821.09 | $14,061.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $9,277.33 / $25,673.92
| Facility | | $1,474.01 | $9,277.33 | $25,673.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,967.04 / $20,174.07 / $28,579.00
| Facility | | $13,967.04 | $20,174.07 | $28,579.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,208.72 / $16,920.55 / $35,535.25
| Facility | | $12,208.72 | $16,920.55 | $35,535.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,462.72 / $16,920.55 / $35,994.07
| Facility | | $11,462.72 | $16,920.55 | $35,994.07 |