- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,919.66 / $14,348.90 / $18,734.50
| Facility | | $6,919.66 | $14,348.90 | $18,734.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,934.23 / $35,088.53
| Facility | | $5,840.42 | $12,934.23 | $35,088.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,107.60 / $13,406.09 / $20,256.75
| Facility | | $8,107.60 | $13,406.09 | $20,256.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,038.02 / $19,038.02 / $19,038.02
| Facility | | $19,038.02 | $19,038.02 | $19,038.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,681.46 / $13,505.42 / $20,855.55
| Facility | | $11,681.46 | $13,505.42 | $20,855.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,934.23 / $35,088.53
| Facility | | $5,840.42 | $12,934.23 | $35,088.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,190.45 / $27,422.00
| Facility | | $5,840.42 | $10,190.45 | $27,422.00 |