- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $9,772.37 / $21,379.62
| Facility | | $7,244.36 | $9,772.37 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $8,128.31 / $13,803.84
| Facility | | $3,019.95 | $8,128.31 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $8,511.38 / $14,791.08
| Facility | | $3,548.13 | $8,511.38 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $9,772.37 / $33,884.42
| Facility | | $7,413.10 | $9,772.37 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,332.54 / $17,378.01
| Facility | | $6,165.95 | $9,332.54 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,709.64 / $12,589.25
| Facility | | $5,888.44 | $8,709.64 | $12,589.25 |