- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $23,442.29 / $33,884.42
| Facility | | $13,182.57 | $23,442.29 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $14,125.38 / $27,542.29
| Facility | | $10,471.29 | $14,125.38 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $22,908.68 / $30,902.95
| Facility | | $15,488.17 | $22,908.68 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $8,511.38 / $8,511.38
| Facility | | $8,511.38 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $15,135.61 / $26,302.68
| Facility | | $8,912.51 | $15,135.61 | $26,302.68 |