- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $9,772.37 / $26,302.68
| Facility | | $4,897.79 | $9,772.37 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $13,182.57 / $16,218.10
| Facility | | $2,691.53 | $13,182.57 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $17,782.79 / $26,915.35
| Facility | | $12,302.69 | $17,782.79 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,882.50 / $17,782.79
| Facility | | $7,943.28 | $12,882.50 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,018.94 / $38,018.94 / $38,018.94
| Facility | | $38,018.94 | $38,018.94 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $15,135.61 / $21,877.62
| Facility | | $3,801.89 | $15,135.61 | $21,877.62 |