- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,335.29 / $19,358.00 / $25,274.70
| Facility | | $9,335.29 | $19,358.00 | $25,274.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,449.54 / $47,337.85
| Facility | | $5,840.42 | $17,449.54 | $47,337.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,937.94 / $18,086.12 / $27,328.34
| Facility | | $10,937.94 | $18,086.12 | $27,328.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,684.15 / $25,684.15 / $25,684.15
| Facility | | $25,684.15 | $25,684.15 | $25,684.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,759.43 / $18,220.13 / $28,136.17
| Facility | | $15,759.43 | $18,220.13 | $28,136.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,449.54 / $47,337.85
| Facility | | $5,840.42 | $17,449.54 | $47,337.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,747.93 / $36,994.94
| Facility | | $5,840.42 | $13,747.93 | $36,994.94 |