- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,944.83 / $16,788.50 / $29,542.90
| Facility | | $9,944.83 | $16,788.50 | $29,542.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,527.00 / $6,155.00 / $10,433.12
| Facility | | $3,527.00 | $6,155.00 | $10,433.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,390.18 / $12,283.59 / $20,310.22
| Facility | | $8,390.18 | $12,283.59 | $20,310.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,046.37 / $15,474.91 / $21,368.08
| Facility | | $9,046.37 | $15,474.91 | $21,368.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,132.20 / $31,132.20 / $36,536.28
| Facility | | $31,132.20 | $31,132.20 | $36,536.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $14,334.74 / $20,898.78
| Facility | | $1,787.00 | $14,334.74 | $20,898.78 |