- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,047.27 / $18,400.09 / $29,626.50
| Facility | | $8,047.27 | $18,400.09 | $29,626.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,604.15 / $22,604.15 / $22,604.15
| Facility | | $22,604.15 | $22,604.15 | $22,604.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $10,071.76 / $26,717.50
| Facility | | $1,474.01 | $10,071.76 | $26,717.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,319.31 / $19,238.49 / $27,253.64
| Facility | | $13,319.31 | $19,238.49 | $27,253.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,642.54 / $16,135.86 / $33,887.29
| Facility | | $11,642.54 | $16,135.86 | $33,887.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,931.14 / $16,135.86 / $34,324.83
| Facility | | $10,931.14 | $16,135.86 | $34,324.83 |