- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $28,183.83 / $36,307.81
| Facility | | $19,054.61 | $28,183.83 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $12,022.64 / $25,703.96
| Facility | | $6,456.54 | $12,022.64 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $13,489.63 / $25,118.86
| Facility | | $9,772.37 | $13,489.63 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $13,489.63 / $25,118.86
| Facility | | $9,772.37 | $13,489.63 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $17,378.01 / $27,542.29
| Facility | | $5,370.32 | $17,378.01 | $27,542.29 |