- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,023.08 / $18,344.80 / $29,537.40
| Facility | | $8,023.08 | $18,344.80 | $29,537.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,083.70 / $14,083.70 / $16,736.40
| Facility | | $14,083.70 | $14,083.70 | $16,736.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,242.69 / $26,471.45
| Facility | | $1,474.01 | $6,242.69 | $26,471.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,279.26 / $19,180.65 / $27,171.69
| Facility | | $13,279.26 | $19,180.65 | $27,171.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,607.53 / $16,087.34 / $33,785.40
| Facility | | $11,607.53 | $16,087.34 | $33,785.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,898.27 / $16,087.34 / $34,221.62
| Facility | | $10,898.27 | $16,087.34 | $34,221.62 |