- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,615.28 / $21,985.40 / $35,399.19
| Facility | | $9,615.28 | $21,985.40 | $35,399.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,318.49 / $19,318.49 / $19,318.49
| Facility | | $19,318.49 | $19,318.49 | $19,318.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $11,501.35 / $30,379.39
| Facility | | $1,474.01 | $11,501.35 | $30,379.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,914.57 / $22,987.10 / $32,563.99
| Facility | | $15,914.57 | $22,987.10 | $32,563.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,911.08 / $19,279.91 / $40,490.19
| Facility | | $13,911.08 | $19,279.91 | $40,490.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,911.08 / $23,429.48 / $41,013.01
| Facility | | $13,911.08 | $23,429.48 | $41,013.01 |