- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,746.79 / $20,211.40 / $26,388.80
| Facility | | $9,746.79 | $20,211.40 | $26,388.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,218.73 / $49,424.55
| Facility | | $5,840.42 | $18,218.73 | $49,424.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,420.09 / $18,883.37 / $28,533.00
| Facility | | $11,420.09 | $18,883.37 | $28,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,816.33 / $26,816.33 / $26,816.33
| Facility | | $26,816.33 | $26,816.33 | $26,816.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,454.12 / $19,023.29 / $29,376.43
| Facility | | $16,454.12 | $19,023.29 | $29,376.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,218.73 / $49,424.55
| Facility | | $5,840.42 | $18,218.73 | $49,424.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,353.95 / $38,625.72
| Facility | | $5,840.42 | $14,353.95 | $38,625.72 |