- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,796.80 / $22,249.70 / $38,928.60
| Facility | | $16,796.80 | $22,249.70 | $38,928.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,450.87 / $17,976.47 / $27,152.88
| Facility | | $11,450.87 | $17,976.47 | $27,152.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $18,812.18 / $38,245.94
| Facility | | $5,939.30 | $18,812.18 | $38,245.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,307.00 / $21,346.76 / $34,756.43
| Facility | | $13,307.00 | $21,346.76 | $34,756.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $22,929.41 / $35,021.83
| Facility | | $3,496.00 | $22,929.41 | $35,021.83 |