- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,339.45 / $14,078.40 / $24,773.90
| Facility | | $8,339.45 | $14,078.40 | $24,773.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,612.39 / $47,612.39 / $47,612.39
| Facility | | $47,612.39 | $47,612.39 | $47,612.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,738.68 / $8,470.86 / $14,006.09
| Facility | | $5,738.68 | $8,470.86 | $14,006.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,586.04 / $12,976.82 / $18,057.00
| Facility | | $7,586.04 | $12,976.82 | $18,057.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,497.35 / $26,497.35 / $31,096.89
| Facility | | $26,497.35 | $26,497.35 | $31,096.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.00 / $12,548.00 / $20,521.81
| Facility | | $3,158.00 | $12,548.00 | $20,521.81 |