- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $8,511.38 / $23,442.29
| Facility | | $5,495.41 | $8,511.38 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $18,197.01 / $28,183.83
| Facility | | $12,589.25 | $18,197.01 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $11,481.54 / $15,488.17
| Facility | | $7,413.10 | $11,481.54 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,884.42 / $33,884.42 / $33,884.42
| Facility | | $33,884.42 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $12,022.64 / $17,782.79
| Facility | | $3,162.28 | $12,022.64 | $17,782.79 |