- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $14,125.38 / $18,197.01
| Facility | | $12,302.69 | $14,125.38 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $13,182.57 / $13,182.57
| Facility | | $13,182.57 | $13,182.57 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $14,791.08 / $25,118.86
| Facility | | $6,309.57 | $14,791.08 | $25,118.86 |
- 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
- $13,182.57 / $16,982.44 / $24,547.09
| Facility | | $13,182.57 | $16,982.44 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $16,218.10 / $25,703.96
| Facility | | $8,128.31 | $16,218.10 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,791.08 / $22,387.21
| Facility | | $9,332.54 | $14,791.08 | $22,387.21 |