- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $19,952.62 / $28,183.83
| Facility | | $13,182.57 | $19,952.62 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $13,803.84 / $14,791.08
| Facility | | $12,022.64 | $13,803.84 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,595.87 / $27,542.29
| Facility | | $6,165.95 | $16,595.87 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,218.10 / $27,542.29
| Facility | | $11,748.98 | $16,218.10 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $18,197.01 / $26,302.68
| Facility | | $14,454.40 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $17,782.79 / $25,703.96
| Facility | | $9,332.54 | $17,782.79 | $25,703.96 |