- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,447.24 / $12,414.50 / $19,166.90
| Facility | | $8,447.24 | $12,414.50 | $19,166.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,363.82 / $36,058.46 / $46,228.79
| Facility | | $25,363.82 | $36,058.46 | $46,228.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.18 / $17,708.18 / $23,248.69
| Facility | | $231.18 | $17,708.18 | $23,248.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,447.24 / $12,697.90 / $20,304.40
| Facility | | $8,447.24 | $12,697.90 | $20,304.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,878.95 / $16,893.14 / $25,665.59
| Facility | | $9,878.95 | $16,893.14 | $25,665.59 |