- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,397.06 / $19,199.90 / $30,914.30
| Facility | | $8,397.06 | $19,199.90 | $30,914.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $12,381.27 / $26,216.92
| Facility | | $1,474.01 | $12,381.27 | $26,216.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,898.26 / $20,074.73 / $28,438.27
| Facility | | $13,898.26 | $20,074.73 | $28,438.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,148.60 / $16,837.23 / $35,360.26
| Facility | | $12,148.60 | $16,837.23 | $35,360.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,406.28 / $16,837.23 / $35,816.83
| Facility | | $11,406.28 | $16,837.23 | $35,816.83 |