- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $19,054.61 / $38,018.94
| Facility | | $8,709.64 | $19,054.61 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $32,359.37 / $39,810.72
| Facility | | $21,379.62 | $32,359.37 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $23,442.29 / $32,359.37
| Facility | | $15,488.17 | $23,442.29 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $23,988.33 / $60,255.96
| Facility | | $13,489.63 | $23,988.33 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $16,982.44 / $32,359.37
| Facility | | $6,456.54 | $16,982.44 | $32,359.37 |