- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,224.30 / $18,948.50 / $33,343.80
| Facility | | $11,224.30 | $18,948.50 | $33,343.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,371.43 / $7,996.34 / $13,147.86
| Facility | | $5,371.43 | $7,996.34 | $13,147.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,917.45 / $17,465.84 / $24,117.20
| Facility | | $9,917.45 | $17,465.84 | $24,117.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,645.35 / $32,645.35 / $38,312.08
| Facility | | $32,645.35 | $32,645.35 | $38,312.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $16,513.41 / $23,587.52
| Facility | | $1,787.00 | $16,513.41 | $23,587.52 |