- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $11,611.47 / $24,068.03
| Facility | | $4,241.22 | $11,611.47 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,999.34 / $17,097.68 / $33,072.44
| Facility | | $12,999.34 | $17,097.68 | $33,072.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,940.82 / $21,940.82 / $21,940.82
| Facility | | $21,940.82 | $21,940.82 | $21,940.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,068.58 / $1,879.84 / $15,622.00
| Facility | | $1,068.58 | $1,879.84 | $15,622.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,932.00 / $2,691.42 / $27,984.26
| Facility | | $1,932.00 | $2,691.42 | $27,984.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |