- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $16,595.87 / $34,673.69
| Facility | | $7,585.78 | $16,595.87 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $29,512.09 / $36,307.81
| Facility | | $19,952.62 | $29,512.09 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $21,379.62 / $30,199.52
| Facility | | $15,488.17 | $21,379.62 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $22,387.21 / $56,234.13
| Facility | | $12,302.69 | $22,387.21 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $16,595.87 / $29,512.09
| Facility | | $5,623.41 | $16,595.87 | $29,512.09 |