- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $15,848.93 / $43,651.58
| Facility | | $10,232.93 | $15,848.93 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $12,882.50 / $26,302.68
| Facility | | $12,882.50 | $12,882.50 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $11,748.98 / $18,620.87
| Facility | | $8,128.31 | $11,748.98 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $21,379.62 / $28,840.32
| Facility | | $13,182.57 | $21,379.62 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63,095.73 / $63,095.73 / $63,095.73
| Facility | | $63,095.73 | $63,095.73 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $22,387.21 / $33,884.42
| Facility | | $2,951.21 | $22,387.21 | $33,884.42 |