- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $21,379.62 / $24,547.09
| Facility | | $16,595.87 | $21,379.62 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $18,197.01 / $21,877.62
| Facility | | $15,488.17 | $18,197.01 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $24,547.09 / $30,902.95
| Facility | | $15,135.61 | $24,547.09 | $30,902.95 |
- 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
- $1,862.09 / $23,988.33 / $31,622.78
| Facility | | $1,862.09 | $23,988.33 | $31,622.78 |