- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,302.69 / $33,884.42
| Facility | | $7,943.28 | $12,302.69 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $9,772.37 / $15,488.17
| Facility | | $6,760.83 | $9,772.37 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,595.87 / $22,387.21
| Facility | | $10,715.19 | $16,595.87 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,977.88 / $48,977.88 / $48,977.88
| Facility | | $48,977.88 | $48,977.88 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $17,378.01 / $26,302.68
| Facility | | $2,951.21 | $17,378.01 | $26,302.68 |