- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,161.60 / $18,842.59 / $33,157.60
| Facility | | $11,161.60 | $18,842.59 | $33,157.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,168.51 / $10,985.22 / $20,989.65
| Facility | | $9,168.51 | $10,985.22 | $20,989.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,414.59 / $9,468.57 / $15,701.24
| Facility | | $6,414.59 | $9,468.57 | $15,701.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,153.23 / $17,368.32 / $23,982.53
| Facility | | $10,153.23 | $17,368.32 | $23,982.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,192.00 / $35,192.00 / $41,300.80
| Facility | | $35,192.00 | $35,192.00 | $41,300.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $16,421.20 / $23,455.81
| Facility | | $1,787.00 | $16,421.20 | $23,455.81 |