- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $16,218.10 / $34,673.69
| Facility | | $7,585.78 | $16,218.10 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $28,840.32 / $36,307.81
| Facility | | $19,498.45 | $28,840.32 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $21,379.62 / $29,512.09
| Facility | | $15,488.17 | $21,379.62 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $21,877.62 / $54,954.09
| Facility | | $11,220.18 | $21,877.62 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $16,595.87 / $29,512.09
| Facility | | $5,623.41 | $16,595.87 | $29,512.09 |