- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $17,378.01 / $39,810.72
| Facility | | $12,022.64 | $17,378.01 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $11,748.98 / $28,840.32
| Facility | | $8,511.38 | $11,748.98 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $10,232.93 / $16,595.87
| Facility | | $4,897.79 | $10,232.93 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $20,417.38 / $26,302.68
| Facility | | $13,803.84 | $20,417.38 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $26,915.35 / $40,738.03
| Facility | | $11,748.98 | $26,915.35 | $40,738.03 |