- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,046.45 / $15,271.90 / $26,874.10
| Facility | | $9,046.45 | $15,271.90 | $26,874.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,502.08 / $6,265.05 / $10,389.01
| Facility | | $4,502.08 | $6,265.05 | $10,389.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,229.17 / $14,076.97 / $19,520.59
| Facility | | $8,229.17 | $14,076.97 | $19,520.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,649.15 / $28,649.15 / $33,622.21
| Facility | | $28,649.15 | $28,649.15 | $33,622.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $13,309.34 / $19,010.87
| Facility | | $1,787.00 | $13,309.34 | $19,010.87 |