- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $18,620.87 / $28,183.83
| Facility | | $13,489.63 | $18,620.87 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $25,118.86 / $25,118.86
| Facility | | $25,118.86 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $16,595.87 / $23,988.33
| Facility | | $10,232.93 | $16,595.87 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $16,218.10 / $28,840.32
| Facility | | $11,481.54 | $16,218.10 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $181.97 / $275.42
| Facility | | $123.03 | $181.97 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $17,782.79 / $26,302.68
| Facility | | $11,748.98 | $17,782.79 | $26,302.68 |