- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,289.16 / $21,239.70 / $34,198.60
| Facility | | $9,289.16 | $21,239.70 | $34,198.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,558.89 / $13,558.89 / $18,946.15
| Facility | | $13,558.89 | $13,558.89 | $18,946.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $13,894.52 / $29,495.31
| Facility | | $1,474.01 | $13,894.52 | $29,495.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,374.80 / $22,207.45 / $31,459.52
| Facility | | $15,374.80 | $22,207.45 | $31,459.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,439.26 / $18,626.00 / $39,116.90
| Facility | | $13,439.26 | $18,626.00 | $39,116.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,439.26 / $22,634.82 / $39,621.98
| Facility | | $13,439.26 | $22,634.82 | $39,621.98 |