- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,440.12 / $21,584.90 / $34,754.40
| Facility | | $9,440.12 | $21,584.90 | $34,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,198.86 / $17,198.86 / $26,890.16
| Facility | | $17,198.86 | $17,198.86 | $26,890.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $12,001.33 / $31,024.62
| Facility | | $1,474.01 | $12,001.33 | $31,024.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,624.66 / $22,568.35 / $31,970.79
| Facility | | $15,624.66 | $22,568.35 | $31,970.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,657.67 / $18,928.70 / $39,752.61
| Facility | | $13,657.67 | $18,928.70 | $39,752.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,823.13 / $18,928.70 / $40,265.89
| Facility | | $12,823.13 | $18,928.70 | $40,265.89 |