- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,648.66 / $18,847.09 / $28,731.30
| Facility | | $9,648.66 | $18,847.09 | $28,731.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,122.24 / $19,450.46 / $41,641.26
| Facility | | $17,122.24 | $19,450.46 | $41,641.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,040.95 / $19,084.98 / $30,294.30
| Facility | | $12,040.95 | $19,084.98 | $30,294.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,517.66 / $11,517.66 / $11,517.66
| Facility | | $11,517.66 | $11,517.66 | $11,517.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,631.38 / $17,643.78 / $38,403.30
| Facility | | $6,631.38 | $17,643.78 | $38,403.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,847.20 / $34,127.18
| Facility | | $3,308.00 | $16,847.20 | $34,127.18 |