- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $21,877.62 / $41,686.94
| Facility | | $8,709.64 | $21,877.62 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $30,902.95 / $43,651.58
| Facility | | $22,387.21 | $30,902.95 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,054.61 / $38,018.94
| Facility | | $12,589.25 | $19,054.61 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $24,547.09 / $42,657.95
| Facility | | $12,022.64 | $24,547.09 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $21,379.62 / $36,307.81
| Facility | | $6,025.60 | $21,379.62 | $36,307.81 |