- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $17,782.79 / $36,307.81
| Facility | | $7,413.10 | $17,782.79 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $27,542.29 / $38,904.51
| Facility | | $19,498.45 | $27,542.29 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $16,595.87 / $33,884.42
| Facility | | $11,220.18 | $16,595.87 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $21,379.62 / $37,153.52
| Facility | | $10,471.29 | $21,379.62 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $19,498.45 / $31,622.78
| Facility | | $5,623.41 | $19,498.45 | $31,622.78 |