- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,073.57 / $18,460.20 / $29,723.30
| Facility | | $8,073.57 | $18,460.20 | $29,723.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,117.95 / $22,117.95 / $22,117.95
| Facility | | $22,117.95 | $22,117.95 | $22,117.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,152.26 / $25,336.77
| Facility | | $1,474.01 | $7,152.26 | $25,336.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,362.84 / $19,301.37 / $27,342.71
| Facility | | $13,362.84 | $19,301.37 | $27,342.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,680.59 / $16,188.59 / $33,998.04
| Facility | | $11,680.59 | $16,188.59 | $33,998.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,966.86 / $16,188.59 / $34,437.01
| Facility | | $10,966.86 | $16,188.59 | $34,437.01 |