- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,238.68 / $18,039.80 / $30,458.40
| Facility | | $8,238.68 | $18,039.80 | $30,458.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,886.00 / $22,681.70 / $43,416.96
| Facility | | $16,886.00 | $22,681.70 | $43,416.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,983.71 / $25,716.00 / $37,749.65
| Facility | | $17,983.71 | $25,716.00 | $37,749.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,233.45 / $25,428.39 / $53,324.14
| Facility | | $13,233.45 | $25,428.39 | $53,324.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,638.03 / $9,638.03 / $9,638.03
| Facility | | $9,638.03 | $9,638.03 | $9,638.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,983.71 / $27,998.56 / $37,957.76
| Facility | | $17,983.71 | $27,998.56 | $37,957.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $23,679.60 / $35,895.00
| Facility | | $5,281.00 | $23,679.60 | $35,895.00 |