- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $18,620.87 / $38,018.94
| Facility | | $8,511.38 | $18,620.87 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $32,359.37 / $39,810.72
| Facility | | $21,877.62 | $32,359.37 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $23,442.29 / $33,113.11
| Facility | | $15,488.17 | $23,442.29 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $23,988.33 / $61,659.50
| Facility | | $13,489.63 | $23,988.33 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $9,120.11 / $9,549.93
| Facility | | $9,120.11 | $9,120.11 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $16,982.44 / $32,359.37
| Facility | | $7,079.46 | $16,982.44 | $32,359.37 |