- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $16,595.87 / $21,379.62
| Facility | | $14,454.40 | $16,595.87 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $7,762.47 / $7,762.47
| Facility | | $7,762.47 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $17,378.01 / $28,840.32
| Facility | | $7,413.10 | $17,378.01 | $28,840.32 |
- 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
- $15,488.17 / $19,952.62 / $27,542.29
| Facility | | $15,488.17 | $19,952.62 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $18,197.01 / $30,902.95
| Facility | | $9,332.54 | $18,197.01 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,982.44 / $26,302.68
| Facility | | $10,964.78 | $16,982.44 | $26,302.68 |