- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $19,498.45 / $31,622.78
| Facility | | $13,803.84 | $19,498.45 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $13,803.84 / $23,988.33
| Facility | | $6,918.31 | $13,803.84 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $20,417.38 / $37,153.52
| Facility | | $12,302.69 | $20,417.38 | $37,153.52 |
- 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
- $7,413.10 / $19,498.45 / $31,622.78
| Facility | | $7,413.10 | $19,498.45 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $17,782.79 / $40,738.03
| Facility | | $12,022.64 | $17,782.79 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $16,595.87 / $37,153.52
| Facility | | $5,623.41 | $16,595.87 | $37,153.52 |