- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,875.27 / $18,006.80 / $28,993.30
| Facility | | $7,875.27 | $18,006.80 | $28,993.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,348.29 / $25,348.29 / $25,348.29
| Facility | | $25,348.29 | $25,348.29 | $25,348.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $9,704.50 / $28,877.64
| Facility | | $1,474.01 | $9,704.50 | $28,877.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,034.62 / $18,827.29 / $26,671.12
| Facility | | $13,034.62 | $18,827.29 | $26,671.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,697.49 / $15,406.19 / $32,613.51
| Facility | | $10,697.49 | $15,406.19 | $32,613.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,697.49 / $15,790.97 / $33,591.18
| Facility | | $10,697.49 | $15,790.97 | $33,591.18 |