- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,840.63 / $14,978.60 / $25,289.80
| Facility | | $6,840.63 | $14,978.60 | $25,289.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,486.93 / $27,433.34 / $35,572.60
| Facility | | $18,486.93 | $27,433.34 | $35,572.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,932.00 / $21,352.18 / $31,343.80
| Facility | | $14,932.00 | $21,352.18 | $31,343.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,987.83 / $21,113.37 / $44,275.41
| Facility | | $10,987.83 | $21,113.37 | $44,275.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,627.27 / $22,979.78 / $31,516.60
| Facility | | $12,627.27 | $22,979.78 | $31,516.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $19,923.55 / $29,871.14
| Facility | | $5,281.00 | $19,923.55 | $29,871.14 |