- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,670.45 / $15,905.80 / $20,767.20
| Facility | | $7,670.45 | $15,905.80 | $20,767.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,337.62 / $38,895.69
| Facility | | $5,840.42 | $14,337.62 | $38,895.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,987.28 / $14,860.67 / $22,454.65
| Facility | | $8,987.28 | $14,860.67 | $22,454.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,103.68 / $21,103.68 / $21,103.68
| Facility | | $21,103.68 | $21,103.68 | $21,103.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,948.92 / $14,970.79 / $23,118.41
| Facility | | $12,948.92 | $14,970.79 | $23,118.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,337.62 / $38,895.69
| Facility | | $5,840.42 | $14,337.62 | $38,895.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,296.15 / $30,397.33
| Facility | | $5,840.42 | $11,296.15 | $30,397.33 |