- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $21,877.62 / $40,738.03
| Facility | | $13,803.84 | $21,877.62 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $20,892.96 / $25,703.96
| Facility | | $10,471.29 | $20,892.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $18,197.01 / $29,512.09
| Facility | | $12,022.64 | $18,197.01 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $17,378.01 / $33,113.11
| Facility | | $9,549.93 | $17,378.01 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $19,054.61 / $27,542.29
| Facility | | $6,309.57 | $19,054.61 | $27,542.29 |