- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $7,585.78 / $22,908.68
| Facility | | $6,309.57 | $7,585.78 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $12,022.64 / $12,022.64
| Facility | | $12,022.64 | $12,022.64 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $7,413.10 / $12,302.69
| Facility | | $3,090.30 | $7,413.10 | $12,302.69 |
- 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
- $6,456.54 / $8,317.64 / $13,182.57
| Facility | | $6,456.54 | $8,317.64 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $8,128.31 / $19,498.45
| Facility | | $3,981.07 | $8,128.31 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $7,762.47 / $10,964.78
| Facility | | $5,128.61 | $7,762.47 | $10,964.78 |