- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,125.38 / $29,512.09
| Facility | | $6,456.54 | $14,125.38 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $25,118.86 / $30,902.95
| Facility | | $16,595.87 | $25,118.86 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $18,620.87 / $25,118.86
| Facility | | $13,489.63 | $18,620.87 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $18,620.87 / $46,773.51
| Facility | | $10,471.29 | $18,620.87 | $46,773.51 |
- 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
- $5,623.41 / $15,135.61 / $25,118.86
| Facility | | $5,623.41 | $15,135.61 | $25,118.86 |