- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $12,022.64 / $25,118.86
| Facility | | $5,128.61 | $12,022.64 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $21,379.62 / $26,915.35
| Facility | | $14,454.40 | $21,379.62 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $16,982.44 / $21,877.62
| Facility | | $12,302.69 | $16,982.44 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $16,218.10 / $40,738.03
| Facility | | $8,912.51 | $16,218.10 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $14,125.38 / $21,877.62
| Facility | | $5,128.61 | $14,125.38 | $21,877.62 |