- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,051.49 / $15,440.30 / $26,069.30
| Facility | | $7,051.49 | $15,440.30 | $26,069.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,768.07 / $23,363.72 / $30,295.55
| Facility | | $15,768.07 | $23,363.72 | $30,295.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,392.27 / $22,010.35 / $32,309.97
| Facility | | $15,392.27 | $22,010.35 | $32,309.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,326.52 / $21,764.19 / $45,640.19
| Facility | | $11,326.52 | $21,764.19 | $45,640.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,392.27 / $23,964.00 / $32,488.09
| Facility | | $15,392.27 | $23,964.00 | $32,488.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $20,537.68 / $30,468.44
| Facility | | $5,281.00 | $20,537.68 | $30,468.44 |