- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $17,378.01 / $28,183.83
| Facility | | $12,302.69 | $17,378.01 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $19,952.62 / $25,703.96
| Facility | | $18,620.87 | $19,952.62 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $12,302.69 / $20,892.96
| Facility | | $6,025.60 | $12,302.69 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $17,782.79 / $33,113.11
| Facility | | $10,715.19 | $17,782.79 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $43,651.58
| Facility | | $43,651.58 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $16,982.44 / $28,183.83
| Facility | | $6,606.93 | $16,982.44 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,848.93 / $36,307.81
| Facility | | $10,715.19 | $15,848.93 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $14,791.08 / $33,113.11
| Facility | | $5,248.07 | $14,791.08 | $33,113.11 |