- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $14,791.08 / $31,622.78
| Facility | | $6,918.31 | $14,791.08 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $26,915.35 / $33,113.11
| Facility | | $17,782.79 | $26,915.35 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $19,498.45 / $26,915.35
| Facility | | $14,791.08 | $19,498.45 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $19,952.62 / $50,118.72
| Facility | | $11,220.18 | $19,952.62 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $7,585.78 / $7,585.78
| Facility | | $7,585.78 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $15,848.93 / $26,915.35
| Facility | | $5,623.41 | $15,848.93 | $26,915.35 |