- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,581.16 / $19,620.80 / $31,592.10
| Facility | | $8,581.16 | $19,620.80 | $31,592.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,952.62 / $16,952.62 / $25,771.63
| Facility | | $16,952.62 | $16,952.62 | $25,771.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,242.69 / $26,700.53
| Facility | | $1,474.01 | $6,242.69 | $26,700.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,202.97 / $20,514.86 / $29,061.76
| Facility | | $14,202.97 | $20,514.86 | $29,061.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,414.95 / $17,206.38 / $36,135.51
| Facility | | $12,414.95 | $17,206.38 | $36,135.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,656.35 / $17,206.38 / $36,602.08
| Facility | | $11,656.35 | $17,206.38 | $36,602.08 |