- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,651.04 / $22,067.10 / $35,530.90
| Facility | | $9,651.04 | $22,067.10 | $35,530.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,749.59 / $19,749.59 / $25,781.03
| Facility | | $19,749.59 | $19,749.59 | $25,781.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $10,970.73 / $30,028.05
| Facility | | $1,474.01 | $10,970.73 | $30,028.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,973.77 / $23,072.61 / $32,685.13
| Facility | | $15,973.77 | $23,072.61 | $32,685.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,109.65 / $19,351.64 / $40,640.82
| Facility | | $13,109.65 | $19,351.64 | $40,640.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,109.65 / $23,610.21 / $34,888.72
| Facility | | $13,109.65 | $23,610.21 | $34,888.72 |