- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,843.29 / $18,337.80 / $23,942.60
| Facility | | $8,843.29 | $18,337.80 | $23,942.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,746.16 / $44,842.97
| Facility | | $5,840.42 | $16,746.16 | $44,842.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,361.46 / $17,132.91 / $25,888.04
| Facility | | $10,361.46 | $17,132.91 | $25,888.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,330.50 / $24,330.50 / $24,330.50
| Facility | | $24,330.50 | $24,330.50 | $24,330.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,928.85 / $17,259.87 / $26,653.29
| Facility | | $14,928.85 | $17,259.87 | $26,653.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,746.16 / $44,842.97
| Facility | | $5,840.42 | $16,746.16 | $44,842.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,746.16 / $35,045.18
| Facility | | $5,840.42 | $16,746.16 | $35,045.18 |