- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $19,952.62 / $33,884.42
| Facility | | $14,125.38 | $19,952.62 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $15,848.93 / $25,703.96
| Facility | | $15,848.93 | $15,848.93 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $17,378.01 / $25,118.86
| Facility | | $10,964.78 | $17,378.01 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $16,982.44 / $30,199.52
| Facility | | $12,022.64 | $16,982.44 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $190.55 / $323.59
| Facility | | $128.82 | $190.55 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,054.61 / $29,512.09
| Facility | | $12,589.25 | $19,054.61 | $29,512.09 |