- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,625.79 / $22,009.40 / $35,437.90
| Facility | | $9,625.79 | $22,009.40 | $35,437.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,302.35 / $22,302.35 / $22,302.35
| Facility | | $22,302.35 | $22,302.35 | $22,302.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $13,355.84 / $31,294.01
| Facility | | $1,474.01 | $13,355.84 | $31,294.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,931.98 / $23,012.25 / $32,599.62
| Facility | | $15,931.98 | $23,012.25 | $32,599.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,926.30 / $19,301.00 / $40,534.50
| Facility | | $13,926.30 | $19,301.00 | $40,534.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,075.35 / $19,301.00 / $41,057.87
| Facility | | $13,075.35 | $19,301.00 | $41,057.87 |