- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $21,379.62 / $43,651.58
| Facility | | $9,549.93 | $21,379.62 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $37,153.52 / $45,708.82
| Facility | | $25,118.86 | $37,153.52 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $26,915.35 / $38,018.94
| Facility | | $15,488.17 | $26,915.35 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $27,542.29 / $70,794.58
| Facility | | $15,488.17 | $27,542.29 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $10,232.93 / $10,232.93
| Facility | | $10,232.93 | $10,232.93 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $22,387.21 / $38,018.94
| Facility | | $6,165.95 | $22,387.21 | $38,018.94 |