- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,664.90 / $20,832.09 / $31,757.40
| Facility | | $10,664.90 | $20,832.09 | $31,757.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,457.38 / $27,457.38 / $27,457.38
| Facility | | $27,457.38 | $27,457.38 | $27,457.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,901.45 / $22,527.11 / $37,080.11
| Facility | | $13,901.45 | $22,527.11 | $37,080.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,730.74 / $20,176.29 / $35,896.83
| Facility | | $12,730.74 | $20,176.29 | $35,896.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $19,214.59 / $39,183.73
| Facility | | $7,117.00 | $19,214.59 | $39,183.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $19,036.31 / $37,721.57
| Facility | | $5,264.00 | $19,036.31 | $37,721.57 |