- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $22,387.21 / $30,199.52
| Facility | | $8,709.64 | $22,387.21 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,884.42 / $33,884.42 / $33,884.42
| Facility | | $33,884.42 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $20,892.96 / $23,442.29
| Facility | | $15,135.61 | $20,892.96 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $23,988.33 / $33,113.11
| Facility | | $19,054.61 | $23,988.33 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $25,703.96 / $34,673.69
| Facility | | $2,041.74 | $25,703.96 | $34,673.69 |