- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $19,054.61 / $39,810.72
| Facility | | $16,982.44 | $19,054.61 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $12,882.50 / $12,882.50
| Facility | | $12,882.50 | $12,882.50 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $19,952.62 / $33,884.42
| Facility | | $8,511.38 | $19,952.62 | $33,884.42 |
- 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
- $15,848.93 / $20,892.96 / $33,113.11
| Facility | | $15,848.93 | $20,892.96 | $33,113.11 |
- 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 / $30,199.52
| Facility | | $12,302.69 | $19,498.45 | $30,199.52 |