- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $18,620.87 / $23,988.33
| Facility | | $15,848.93 | $18,620.87 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $16,982.44 / $16,982.44
| Facility | | $16,982.44 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $19,054.61 / $33,113.11
| Facility | | $8,128.31 | $19,054.61 | $33,113.11 |
- 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
- $16,982.44 / $22,387.21 / $31,622.78
| Facility | | $16,982.44 | $22,387.21 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $20,417.38 / $33,884.42
| Facility | | $10,232.93 | $20,417.38 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $19,054.61 / $28,840.32
| Facility | | $12,022.64 | $19,054.61 | $28,840.32 |