- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,850.83 / $18,044.30 / $25,548.80
| Facility | | $9,850.83 | $18,044.30 | $25,548.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,066.79 / $18,066.79 / $18,066.79
| Facility | | $18,066.79 | $18,066.79 | $18,066.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,026.97 / $17,736.91 / $28,343.44
| Facility | | $11,026.97 | $17,736.91 | $28,343.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,241.87 / $16,148.03 / $28,879.00
| Facility | | $10,241.87 | $16,148.03 | $28,879.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,517.56 / $15,314.71 / $34,149.47
| Facility | | $6,517.56 | $15,314.71 | $34,149.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,517.56 / $15,831.56 / $34,149.47
| Facility | | $6,517.56 | $15,831.56 | $34,149.47 |