- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $17,782.79 / $33,113.11
| Facility | | $11,481.54 | $17,782.79 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $18,620.87 / $21,379.62
| Facility | | $16,218.10 | $18,620.87 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $15,135.61 / $23,988.33
| Facility | | $9,772.37 | $15,135.61 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $11,220.18 / $23,988.33
| Facility | | $5,128.61 | $11,220.18 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $15,848.93 / $22,387.21
| Facility | | $6,309.57 | $15,848.93 | $22,387.21 |