- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $10,964.78 / $21,379.62
| Facility | | $3,090.30 | $10,964.78 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $17,782.79 / $22,387.21
| Facility | | $12,022.64 | $17,782.79 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $15,488.17 / $18,620.87
| Facility | | $10,232.93 | $15,488.17 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $13,489.63 / $33,884.42
| Facility | | $7,585.78 | $13,489.63 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $12,022.64 / $18,620.87
| Facility | | $4,570.88 | $12,022.64 | $18,620.87 |