- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,242.87 / $21,133.80 / $34,028.19
| Facility | | $9,242.87 | $21,133.80 | $34,028.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,254.41 / $19,254.41 / $19,254.41
| Facility | | $19,254.41 | $19,254.41 | $19,254.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $16,117.19 / $31,760.65
| Facility | | $1,474.01 | $16,117.19 | $31,760.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,298.18 / $22,096.79 / $31,302.76
| Facility | | $15,298.18 | $22,096.79 | $31,302.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,555.19 / $18,081.59 / $38,277.08
| Facility | | $12,555.19 | $18,081.59 | $38,277.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,555.19 / $18,021.84 / $33,413.16
| Facility | | $12,555.19 | $18,021.84 | $33,413.16 |