- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $14,791.08 / $19,054.61
| Facility | | $12,882.50 | $14,791.08 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $20,892.96 / $20,892.96
| Facility | | $20,892.96 | $20,892.96 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $15,488.17 / $26,302.68
| Facility | | $6,606.93 | $15,488.17 | $26,302.68 |
- 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
- $13,803.84 / $17,782.79 / $25,703.96
| Facility | | $13,803.84 | $17,782.79 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $16,218.10 / $27,542.29
| Facility | | $8,511.38 | $16,218.10 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $15,135.61 / $23,442.29
| Facility | | $9,772.37 | $15,135.61 | $23,442.29 |