- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,487.45 / $21,693.10 / $34,928.60
| Facility | | $9,487.45 | $21,693.10 | $34,928.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,387.49 / $20,387.49 / $20,387.49
| Facility | | $20,387.49 | $20,387.49 | $20,387.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $11,974.52 / $31,212.56
| Facility | | $1,474.01 | $11,974.52 | $31,212.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,703.01 / $22,681.53 / $32,131.11
| Facility | | $15,703.01 | $22,681.53 | $32,131.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,726.16 / $19,023.62 / $39,951.96
| Facility | | $13,726.16 | $19,023.62 | $39,951.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,887.44 / $19,023.62 / $40,467.81
| Facility | | $12,887.44 | $19,023.62 | $40,467.81 |