- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $19,498.45 / $30,199.52
| Facility | | $15,135.61 | $19,498.45 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $20,892.96 / $23,442.29
| Facility | | $10,715.19 | $20,892.96 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $19,054.61 / $28,840.32
| Facility | | $6,918.31 | $19,054.61 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $15,488.17 / $28,840.32
| Facility | | $11,220.18 | $15,488.17 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $12,882.50 / $23,442.29
| Facility | | $3,311.31 | $12,882.50 | $23,442.29 |