- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $14,791.08 / $30,902.95
| Facility | | $6,760.83 | $14,791.08 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $26,302.68 / $33,113.11
| Facility | | $17,782.79 | $26,302.68 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,054.61 / $26,915.35
| Facility | | $14,454.40 | $19,054.61 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $19,952.62 / $50,118.72
| Facility | | $10,964.78 | $19,952.62 | $50,118.72 |
- 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 |