- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,589.58 / $18,808.09 / $31,755.70
| Facility | | $8,589.58 | $18,808.09 | $31,755.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,212.75 / $31,431.16 / $42,431.00
| Facility | | $21,212.75 | $31,431.16 | $42,431.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,749.66 / $26,811.30 / $39,357.49
| Facility | | $18,749.66 | $26,811.30 | $39,357.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,797.09 / $26,511.44 / $55,595.33
| Facility | | $13,797.09 | $26,511.44 | $55,595.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,749.66 / $29,191.08 / $39,574.47
| Facility | | $18,749.66 | $29,191.08 | $39,574.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,848.66 / $23,507.19 / $37,114.29
| Facility | | $8,848.66 | $23,507.19 | $37,114.29 |