- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $19,498.45 / $37,153.52
| Facility | | $7,943.28 | $19,498.45 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $28,183.83 / $39,810.72
| Facility | | $19,952.62 | $28,183.83 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $16,982.44 / $34,673.69
| Facility | | $11,481.54 | $16,982.44 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $21,877.62 / $38,018.94
| Facility | | $10,715.19 | $21,877.62 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $19,498.45 / $32,359.37
| Facility | | $5,623.41 | $19,498.45 | $32,359.37 |