- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,574.85 / $19,606.40 / $31,568.80
| Facility | | $8,574.85 | $19,606.40 | $31,568.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,765.12 / $17,765.12 / $24,022.50
| Facility | | $17,765.12 | $17,765.12 | $24,022.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $10,202.56 / $28,317.67
| Facility | | $1,474.01 | $10,202.56 | $28,317.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,192.52 / $20,499.77 / $29,040.38
| Facility | | $14,192.52 | $20,499.77 | $29,040.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,405.82 / $17,193.72 / $36,108.93
| Facility | | $12,405.82 | $17,193.72 | $36,108.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,647.78 / $17,193.72 / $36,575.17
| Facility | | $11,647.78 | $17,193.72 | $36,575.17 |