- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $25,118.86 / $35,481.34
| Facility | | $13,803.84 | $25,118.86 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $26,915.35 / $40,738.03
| Facility | | $16,595.87 | $26,915.35 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $23,442.29 / $33,884.42
| Facility | | $13,182.57 | $23,442.29 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $26,915.35 / $32,359.37
| Facility | | $26,915.35 | $26,915.35 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $25,703.96 / $31,622.78
| Facility | | $11,220.18 | $25,703.96 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $33,113.11 / $57,543.99
| Facility | | $18,620.87 | $33,113.11 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $22,908.68 / $33,884.42
| Facility | | $13,803.84 | $22,908.68 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $13,182.57 / $21,877.62
| Facility | | $11,481.54 | $13,182.57 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $18,197.01 / $31,622.78
| Facility | | $5,370.32 | $18,197.01 | $31,622.78 |