- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $14,454.40 / $18,620.87
| Facility | | $12,589.25 | $14,454.40 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $12,022.64 / $18,620.87
| Facility | | $6,760.83 | $12,022.64 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $15,135.61 / $25,118.86
| Facility | | $6,456.54 | $15,135.61 | $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
- $12,882.50 / $17,378.01 / $23,988.33
| Facility | | $12,882.50 | $17,378.01 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $16,595.87 / $26,915.35
| Facility | | $8,317.64 | $16,595.87 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $15,135.61 / $22,908.68
| Facility | | $9,549.93 | $15,135.61 | $22,908.68 |