- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,292.18 / $20,346.59 / $34,353.19
| Facility | | $9,292.18 | $20,346.59 | $34,353.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,559.07 / $31,518.92 / $40,515.03
| Facility | | $20,559.07 | $31,518.92 | $40,515.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,283.34 / $29,004.39 / $42,576.82
| Facility | | $20,283.34 | $29,004.39 | $42,576.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,925.65 / $28,680.00 / $60,142.87
| Facility | | $14,925.65 | $28,680.00 | $60,142.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,526.65 / $10,526.65 / $10,526.65
| Facility | | $10,526.65 | $10,526.65 | $10,526.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,283.34 / $31,578.83 / $42,811.55
| Facility | | $20,283.34 | $31,578.83 | $42,811.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,876.37 / $26,707.59 / $40,150.12
| Facility | | $5,876.37 | $26,707.59 | $40,150.12 |