- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $22,908.68 / $32,359.37
| Facility | | $15,135.61 | $22,908.68 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $23,988.33 / $40,738.03
| Facility | | $8,912.51 | $23,988.33 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $18,620.87 / $30,902.95
| Facility | | $13,489.63 | $18,620.87 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $19,054.61 / $26,302.68
| Facility | | $2,691.53 | $19,054.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $17,378.01 / $26,302.68
| Facility | | $2,630.27 | $17,378.01 | $26,302.68 |