- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $16,218.10 / $30,902.95
| Facility | | $6,760.83 | $16,218.10 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $26,302.68 / $32,359.37
| Facility | | $17,782.79 | $26,302.68 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,054.61 / $26,302.68
| Facility | | $14,454.40 | $19,054.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $19,498.45 / $50,118.72
| Facility | | $10,964.78 | $19,498.45 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $8,128.31 / $8,128.31
| Facility | | $8,128.31 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $15,848.93 / $26,302.68
| Facility | | $5,623.41 | $15,848.93 | $26,302.68 |