- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $21,379.62 / $34,673.69
| Facility | | $14,125.38 | $21,379.62 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $14,125.38 / $24,547.09
| Facility | | $7,079.46 | $14,125.38 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $239.88 / $239.88
| Facility | | $239.88 | $239.88 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $23,442.29 / $41,686.94
| Facility | | $13,182.57 | $23,442.29 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,480.75 / $52,480.75 / $52,480.75
| Facility | | $52,480.75 | $52,480.75 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $18,620.87 / $34,673.69
| Facility | | $8,128.31 | $18,620.87 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $19,054.61 / $44,668.36
| Facility | | $13,182.57 | $19,054.61 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $17,782.79 / $40,738.03
| Facility | | $5,888.44 | $17,782.79 | $40,738.03 |