- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $16,982.44 / $27,542.29
| Facility | | $11,481.54 | $16,982.44 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $24,547.09 / $24,547.09
| Facility | | $24,547.09 | $24,547.09 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $11,748.98 / $19,952.62
| Facility | | $5,623.41 | $11,748.98 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $17,782.79 / $32,359.37
| Facility | | $10,715.19 | $17,782.79 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,657.95 / $42,657.95 / $42,657.95
| Facility | | $42,657.95 | $42,657.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $15,488.17 / $27,542.29
| Facility | | $6,606.93 | $15,488.17 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,488.17 / $35,481.34
| Facility | | $10,715.19 | $15,488.17 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $14,454.40 / $32,359.37
| Facility | | $5,248.07 | $14,454.40 | $32,359.37 |