- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $19,054.61 / $24,547.09
| Facility | | $16,218.10 | $19,054.61 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $13,489.63
| Facility | | $13,489.63 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $19,054.61 / $33,113.11
| Facility | | $8,317.64 | $19,054.61 | $33,113.11 |
- 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
- $17,378.01 / $22,908.68 / $36,307.81
| Facility | | $17,378.01 | $22,908.68 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $20,892.96 / $34,673.69
| Facility | | $10,471.29 | $20,892.96 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,498.45 / $29,512.09
| Facility | | $12,302.69 | $19,498.45 | $29,512.09 |