- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,190.48 / $14,910.50 / $19,467.70
| Facility | | $7,190.48 | $14,910.50 | $19,467.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,440.46 / $36,461.86
| Facility | | $5,840.42 | $13,440.46 | $36,461.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,424.92 / $13,930.79 / $21,049.58
| Facility | | $8,424.92 | $13,930.79 | $21,049.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,783.15 / $19,783.15 / $19,783.15
| Facility | | $19,783.15 | $19,783.15 | $19,783.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,138.66 / $14,034.01 / $21,671.81
| Facility | | $12,138.66 | $14,034.01 | $21,671.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,440.46 / $36,461.86
| Facility | | $5,840.42 | $13,440.46 | $36,461.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,589.31 / $28,495.27
| Facility | | $5,840.42 | $10,589.31 | $28,495.27 |