- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $15,488.17 / $33,113.11
| Facility | | $6,760.83 | $15,488.17 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $28,183.83 / $34,673.69
| Facility | | $18,620.87 | $28,183.83 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $20,417.38 / $28,183.83
| Facility | | $15,135.61 | $20,417.38 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $20,892.96 / $52,480.75
| Facility | | $11,748.98 | $20,892.96 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $8,912.51 / $9,549.93
| Facility | | $8,912.51 | $8,912.51 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,595.87 / $28,183.83
| Facility | | $6,165.95 | $16,595.87 | $28,183.83 |