- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,488.17 / $25,118.86
| Facility | | $10,964.78 | $15,488.17 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $16,982.44 / $25,118.86
| Facility | | $12,302.69 | $16,982.44 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $10,715.19 / $18,197.01
| Facility | | $5,248.07 | $10,715.19 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $15,848.93 / $28,840.32
| Facility | | $9,549.93 | $15,848.93 | $28,840.32 |
- 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
- $5,888.44 / $15,135.61 / $25,118.86
| Facility | | $5,888.44 | $15,135.61 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,803.84 / $32,359.37
| Facility | | $9,549.93 | $13,803.84 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $13,182.57 / $28,183.83
| Facility | | $5,248.07 | $13,182.57 | $28,183.83 |