- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,125.38 / $30,199.52
| Facility | | $6,456.54 | $14,125.38 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,118.86 / $31,622.78
| Facility | | $16,982.44 | $25,118.86 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $18,620.87 / $25,703.96
| Facility | | $13,803.84 | $18,620.87 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $19,054.61 / $47,863.01
| Facility | | $10,715.19 | $19,054.61 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $7,762.47 / $7,762.47
| Facility | | $7,762.47 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $15,488.17 / $25,703.96
| Facility | | $5,495.41 | $15,488.17 | $25,703.96 |