- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $17,782.79 / $21,877.62
| Facility | | $14,791.08 | $17,782.79 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $13,803.84 / $20,892.96
| Facility | | $3,890.45 | $13,803.84 | $20,892.96 |
- 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
- $15,135.61 / $19,952.62 / $28,840.32
| Facility | | $15,135.61 | $19,952.62 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $18,197.01 / $25,703.96
| Facility | | $9,120.11 | $18,197.01 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $18,197.01 / $26,302.68
| Facility | | $9,332.54 | $18,197.01 | $26,302.68 |