- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $19,952.62 / $32,359.37
| Facility | | $19,952.62 | $19,952.62 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $22,908.68 / $33,884.42
| Facility | | $16,982.44 | $22,908.68 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $17,782.79 / $23,442.29
| Facility | | $9,332.54 | $17,782.79 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $11,481.54 / $18,197.01
| Facility | | $11,481.54 | $11,481.54 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $22,387.21 / $39,810.72
| Facility | | $22,387.21 | $22,387.21 | $39,810.72 |