- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $30,199.52 / $69,183.10
| Facility | | $21,877.62 | $30,199.52 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $28,840.32
| Facility | | $13,489.63 | $13,489.63 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $22,908.68 / $44,668.36
| Facility | | $10,232.93 | $22,908.68 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $19,952.62 / $151,356.12
| Facility | | $19,952.62 | $19,952.62 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $28,183.83 / $44,668.36
| Facility | | $19,952.62 | $28,183.83 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $26,915.35 / $70,794.58
| Facility | | $14,125.38 | $26,915.35 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $23,988.33 / $45,708.82
| Facility | | $14,125.38 | $23,988.33 | $45,708.82 |