- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,412.32 / $19,234.80 / $30,970.40
| Facility | | $8,412.32 | $19,234.80 | $30,970.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,904.05 / $17,904.05 / $20,175.18
| Facility | | $17,904.05 | $17,904.05 | $20,175.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $10,607.39 / $27,482.80
| Facility | | $1,474.01 | $10,607.39 | $27,482.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,923.51 / $20,111.20 / $28,489.93
| Facility | | $13,923.51 | $20,111.20 | $28,489.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,170.67 / $16,867.82 / $35,424.50
| Facility | | $12,170.67 | $16,867.82 | $35,424.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,427.00 / $16,867.82 / $35,881.89
| Facility | | $11,427.00 | $16,867.82 | $35,881.89 |