- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $28,840.32 / $54,954.09
| Facility | | $11,220.18 | $28,840.32 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $41,686.94 / $58,884.37
| Facility | | $12,589.25 | $41,686.94 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $33,884.42 / $47,863.01
| Facility | | $15,488.17 | $33,884.42 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $35,481.34 / $89,125.09
| Facility | | $19,498.45 | $35,481.34 | $89,125.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $13,182.57 / $13,182.57
| Facility | | $13,182.57 | $13,182.57 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $23,442.29 / $46,773.51
| Facility | | $8,317.64 | $23,442.29 | $46,773.51 |