- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $18,620.87 / $24,547.09
| Facility | | $12,589.25 | $18,620.87 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $28,840.32 / $28,840.32
| Facility | | $28,840.32 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $18,620.87 / $24,547.09
| Facility | | $8,912.51 | $18,620.87 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $15,488.17 / $23,442.29
| Facility | | $10,232.93 | $15,488.17 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $15,135.61 / $21,379.62
| Facility | | $6,165.95 | $15,135.61 | $21,379.62 |