- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,173.79 / $17,175.09 / $30,223.20
| Facility | | $10,173.79 | $17,175.09 | $30,223.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,689.31 / $11,284.52 / $18,667.68
| Facility | | $7,689.31 | $11,284.52 | $18,667.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,254.67 / $15,831.23 / $21,860.08
| Facility | | $9,254.67 | $15,831.23 | $21,860.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,672.80 / $31,672.80 / $37,170.72
| Facility | | $31,672.80 | $31,672.80 | $37,170.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $14,967.93 / $21,379.98
| Facility | | $1,787.00 | $14,967.93 | $21,379.98 |