- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $20,417.38 / $33,113.11
| Facility | | $13,489.63 | $20,417.38 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $22,387.21 / $30,902.95
| Facility | | $19,952.62 | $22,387.21 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $13,489.63 / $23,442.29
| Facility | | $6,456.54 | $13,489.63 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $20,892.96 / $38,904.51
| Facility | | $12,882.50 | $20,892.96 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,286.14 / $51,286.14 / $51,286.14
| Facility | | $51,286.14 | $51,286.14 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $17,782.79 / $33,113.11
| Facility | | $7,762.47 | $17,782.79 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $18,620.87 / $42,657.95
| Facility | | $12,589.25 | $18,620.87 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $17,378.01 / $38,904.51
| Facility | | $5,888.44 | $17,378.01 | $38,904.51 |