- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,600.49 / $15,760.70 / $20,577.80
| Facility | | $7,600.49 | $15,760.70 | $20,577.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,206.84 / $38,540.92
| Facility | | $5,840.42 | $14,206.84 | $38,540.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,905.31 / $14,725.12 / $22,249.84
| Facility | | $8,905.31 | $14,725.12 | $22,249.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,911.18 / $20,911.18 / $20,911.18
| Facility | | $20,911.18 | $20,911.18 | $20,911.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,830.81 / $14,834.23 / $22,907.54
| Facility | | $12,830.81 | $14,834.23 | $22,907.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,206.84 / $38,540.92
| Facility | | $5,840.42 | $14,206.84 | $38,540.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,193.11 / $30,120.07
| Facility | | $5,840.42 | $11,193.11 | $30,120.07 |