- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,772.37 / $26,915.35
| Facility | | $6,309.57 | $9,772.37 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,762.47 / $12,302.69
| Facility | | $5,370.32 | $7,762.47 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $13,182.57 / $17,782.79
| Facility | | $8,128.31 | $13,182.57 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $13,489.63 / $20,892.96
| Facility | | $2,951.21 | $13,489.63 | $20,892.96 |