- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $21,379.62 / $30,199.52
| Facility | | $13,182.57 | $21,379.62 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $22,908.68 / $22,908.68
| Facility | | $22,908.68 | $22,908.68 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $24,547.09 / $33,884.42
| Facility | | $15,848.93 | $24,547.09 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $21,379.62 / $34,673.69
| Facility | | $13,489.63 | $21,379.62 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $18,620.87 / $36,307.81
| Facility | | $4,073.80 | $18,620.87 | $36,307.81 |