- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,203.28 / $13,363.90 / $22,563.20
| Facility | | $6,203.28 | $13,363.90 | $22,563.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,831.16 / $22,305.65 / $28,672.12
| Facility | | $14,831.16 | $22,305.65 | $28,672.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.19 / $17,772.54 / $28,416.42
| Facility | | $14,056.19 | $17,772.54 | $28,416.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,964.07 / $19,146.20 / $40,150.18
| Facility | | $9,964.07 | $19,146.20 | $40,150.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,125.45 / $7,575.85 / $8,165.89
| Facility | | $7,125.45 | $7,575.85 | $8,165.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.19 / $19,019.75 / $28,423.44
| Facility | | $14,056.19 | $19,019.75 | $28,423.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $15,806.00 / $24,445.92
| Facility | | $4,870.00 | $15,806.00 | $24,445.92 |