- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $11,748.98 / $32,359.37
| Facility | | $7,585.78 | $11,748.98 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,549.93 / $9,549.93
| Facility | | $9,549.93 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,848.93 / $24,547.09
| Facility | | $10,964.78 | $15,848.93 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $15,848.93 / $21,379.62
| Facility | | $10,232.93 | $15,848.93 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $46,773.51 / $46,773.51
| Facility | | $46,773.51 | $46,773.51 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $16,218.10 / $25,118.86
| Facility | | $2,951.21 | $16,218.10 | $25,118.86 |