- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $8,511.38 / $11,220.18
| Facility | | $7,413.10 | $8,511.38 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $8,912.51 / $14,125.38
| Facility | | $4,786.30 | $8,912.51 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $9,120.11 / $15,488.17
| Facility | | $3,801.89 | $9,120.11 | $15,488.17 |
- 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
- $7,943.28 / $10,232.93 / $15,848.93
| Facility | | $7,943.28 | $10,232.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $9,772.37 / $15,848.93
| Facility | | $4,897.79 | $9,772.37 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,120.11 / $13,489.63
| Facility | | $6,309.57 | $9,120.11 | $13,489.63 |