- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,449.66 / $19,320.20 / $31,107.90
| Facility | | $8,449.66 | $19,320.20 | $31,107.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,997.75 / $27,328.38
| Facility | | $1,474.01 | $6,997.75 | $27,328.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,985.32 / $20,200.48 / $28,616.41
| Facility | | $13,985.32 | $20,200.48 | $28,616.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,224.70 / $16,942.70 / $35,581.76
| Facility | | $12,224.70 | $16,942.70 | $35,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,477.73 / $16,942.70 / $36,041.19
| Facility | | $11,477.73 | $16,942.70 | $36,041.19 |