- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,078.74 / $17,689.59 / $29,867.10
| Facility | | $8,078.74 | $17,689.59 | $29,867.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,183.48 / $28,093.90 / $36,429.14
| Facility | | $19,183.48 | $28,093.90 | $36,429.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,634.59 / $25,216.78 / $37,016.82
| Facility | | $17,634.59 | $25,216.78 | $37,016.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,976.55 / $24,934.75 / $52,288.97
| Facility | | $12,976.55 | $24,934.75 | $52,288.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,634.59 / $27,455.03 / $37,220.90
| Facility | | $17,634.59 | $27,455.03 | $37,220.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $23,278.80 / $35,277.61
| Facility | | $5,281.00 | $23,278.80 | $35,277.61 |