- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $19,054.61 / $28,840.32
| Facility | | $13,803.84 | $19,054.61 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $16,982.44 / $24,547.09
| Facility | | $10,471.29 | $16,982.44 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,595.87 / $29,512.09
| Facility | | $11,748.98 | $16,595.87 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $186.21 / $281.84
| Facility | | $125.89 | $186.21 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $18,197.01 / $26,915.35
| Facility | | $12,022.64 | $18,197.01 | $26,915.35 |