- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,754.71 / $16,080.50 / $20,995.30
| Facility | | $7,754.71 | $16,080.50 | $20,995.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,495.11 / $39,322.96
| Facility | | $5,840.42 | $14,495.11 | $39,322.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,086.01 / $15,023.91 / $22,701.31
| Facility | | $9,086.01 | $15,023.91 | $22,701.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,335.50 / $21,335.50 / $21,335.50
| Facility | | $21,335.50 | $21,335.50 | $21,335.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,091.16 / $15,135.24 / $23,372.36
| Facility | | $13,091.16 | $15,135.24 | $23,372.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,495.11 / $39,322.96
| Facility | | $5,840.42 | $14,495.11 | $39,322.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,420.23 / $30,731.24
| Facility | | $5,840.42 | $11,420.23 | $30,731.24 |