- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $17,782.79 / $33,884.42
| Facility | | $13,182.57 | $17,782.79 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $10,232.93 / $12,589.25
| Facility | | $10,232.93 | $10,232.93 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $16,982.44 / $22,908.68
| Facility | | $8,128.31 | $16,982.44 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $18,197.01 / $23,988.33
| Facility | | $11,481.54 | $18,197.01 | $23,988.33 |