- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $25,703.96 / $39,810.72
| Facility | | $11,481.54 | $25,703.96 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $22,387.21 / $83,176.38
| Facility | | $6,165.95 | $22,387.21 | $83,176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $22,908.68 / $33,884.42
| Facility | | $13,489.63 | $22,908.68 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $21,877.62 / $58,884.37
| Facility | | $6,165.95 | $21,877.62 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $22,387.21 / $83,176.38
| Facility | | $6,165.95 | $22,387.21 | $83,176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $17,782.79 / $51,286.14
| Facility | | $6,165.95 | $17,782.79 | $51,286.14 |