- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $11,220.18 / $14,454.40
| Facility | | $9,549.93 | $11,220.18 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $12,302.69 / $22,387.21
| Facility | | $9,332.54 | $12,302.69 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,748.98 / $20,417.38
| Facility | | $4,897.79 | $11,748.98 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $13,489.63 / $25,703.96
| Facility | | $10,232.93 | $13,489.63 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $12,882.50 / $20,417.38
| Facility | | $6,456.54 | $12,882.50 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $11,748.98 / $17,378.01
| Facility | | $7,943.28 | $11,748.98 | $17,378.01 |