- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,070.29 / $23,025.70 / $37,074.30
| Facility | | $10,070.29 | $23,025.70 | $37,074.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,516.14 / $20,516.14 / $20,516.14
| Facility | | $20,516.14 | $20,516.14 | $20,516.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $12,542.81 / $31,981.25
| Facility | | $1,474.01 | $12,542.81 | $31,981.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,667.64 / $24,074.84 / $34,104.90
| Facility | | $16,667.64 | $24,074.84 | $34,104.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,569.35 / $20,192.23 / $42,406.18
| Facility | | $14,569.35 | $20,192.23 | $42,406.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,679.10 / $20,192.23 / $42,953.72
| Facility | | $13,679.10 | $20,192.23 | $42,953.72 |