- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $17,782.79 / $57,543.99
| Facility | | $6,918.31 | $17,782.79 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $16,595.87 / $16,595.87
| Facility | | $16,595.87 | $16,595.87 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,952.62 / $33,884.42
| Facility | | $12,589.25 | $19,952.62 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,218.10 / $36,307.81
| Facility | | $11,748.98 | $16,218.10 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $14,454.40 / $34,673.69
| Facility | | $10,232.93 | $14,454.40 | $34,673.69 |