- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,485.87 / $21,689.50 / $34,922.80
| Facility | | $9,485.87 | $21,689.50 | $34,922.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,972.20 / $24,972.20 / $24,972.20
| Facility | | $24,972.20 | $24,972.20 | $24,972.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $12,998.45 / $30,879.97
| Facility | | $1,474.01 | $12,998.45 | $30,879.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,700.40 / $22,677.76 / $32,125.77
| Facility | | $15,700.40 | $22,677.76 | $32,125.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,723.87 / $19,020.46 / $39,945.31
| Facility | | $13,723.87 | $19,020.46 | $39,945.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,885.29 / $19,020.46 / $40,461.08
| Facility | | $12,885.29 | $19,020.46 | $40,461.08 |