- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,224.01 / $18,804.20 / $30,277.20
| Facility | | $8,224.01 | $18,804.20 | $30,277.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $9,450.44 / $26,690.07
| Facility | | $1,474.01 | $9,450.44 | $26,690.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,611.83 / $19,661.00 / $27,852.19
| Facility | | $13,611.83 | $19,661.00 | $27,852.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,898.24 / $16,490.23 / $34,631.53
| Facility | | $11,898.24 | $16,490.23 | $34,631.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,171.21 / $16,490.23 / $35,078.69
| Facility | | $11,171.21 | $16,490.23 | $35,078.69 |