- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $17,782.79 / $37,153.52
| Facility | | $8,128.31 | $17,782.79 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $31,622.78 / $38,904.51
| Facility | | $20,892.96 | $31,622.78 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $22,908.68 / $31,622.78
| Facility | | $15,488.17 | $22,908.68 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $23,442.29 / $58,884.37
| Facility | | $13,182.57 | $23,442.29 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $9,772.37 / $9,772.37
| Facility | | $9,772.37 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $16,595.87 / $31,622.78
| Facility | | $6,918.31 | $16,595.87 | $31,622.78 |