- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $7,943.28 / $10,232.93
| Facility | | $6,918.31 | $7,943.28 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $8,317.64 / $14,125.38
| Facility | | $3,548.13 | $8,317.64 | $14,125.38 |
- 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
- $7,413.10 / $9,549.93 / $14,125.38
| Facility | | $7,413.10 | $9,549.93 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $9,120.11 / $14,791.08
| Facility | | $4,570.88 | $9,120.11 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,709.64 / $12,589.25
| Facility | | $5,888.44 | $8,709.64 | $12,589.25 |