- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,191.80 / $24,164.10 / $34,213.80
| Facility | | $13,191.80 | $24,164.10 | $34,213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,331.88 / $24,331.88 / $24,331.88
| Facility | | $24,331.88 | $24,331.88 | $24,331.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,474.72 / $21,690.05 / $34,128.19
| Facility | | $13,474.72 | $21,690.05 | $34,128.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,715.46 / $21,736.93 / $38,673.44
| Facility | | $13,715.46 | $21,736.93 | $38,673.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $20,439.68 / $45,731.42
| Facility | | $7,117.00 | $20,439.68 | $45,731.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $20,061.98 / $40,639.32
| Facility | | $3,308.00 | $20,061.98 | $40,639.32 |