- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $9,772.37 / $23,442.29
| Facility | | $4,677.35 | $9,772.37 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $17,378.01 / $26,915.35
| Facility | | $8,912.51 | $17,378.01 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $21,877.62 / $25,703.96
| Facility | | $20,892.96 | $21,877.62 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $14,454.40 / $23,442.29
| Facility | | $8,912.51 | $14,454.40 | $23,442.29 |