- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,959.43 / $18,199.30 / $29,303.10
| Facility | | $7,959.43 | $18,199.30 | $29,303.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,264.64 / $26,425.83
| Facility | | $1,474.01 | $7,264.64 | $26,425.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,173.92 / $19,028.49 / $26,956.14
| Facility | | $13,173.92 | $19,028.49 | $26,956.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,515.45 / $15,959.72 / $33,517.37
| Facility | | $11,515.45 | $15,959.72 | $33,517.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,811.81 / $15,959.72 / $33,950.16
| Facility | | $10,811.81 | $15,959.72 | $33,950.16 |