- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,595.87 / $26,915.35
| Facility | | $11,748.98 | $16,595.87 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $19,054.61 / $19,498.45
| Facility | | $18,197.01 | $19,054.61 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $13,182.57 / $23,988.33
| Facility | | $7,079.46 | $13,182.57 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $18,620.87 / $32,359.37
| Facility | | $10,471.29 | $18,620.87 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,686.94 / $41,686.94 / $41,686.94
| Facility | | $41,686.94 | $41,686.94 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $16,595.87 / $26,915.35
| Facility | | $6,309.57 | $16,595.87 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $15,135.61 / $34,673.69
| Facility | | $10,232.93 | $15,135.61 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $14,125.38 / $31,622.78
| Facility | | $5,248.07 | $14,125.38 | $31,622.78 |