- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,800.20 / $20,322.09 / $26,533.40
| Facility | | $9,800.20 | $20,322.09 | $26,533.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,318.57 / $49,695.40
| Facility | | $5,840.42 | $18,318.57 | $49,695.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,482.68 / $18,986.84 / $28,689.36
| Facility | | $11,482.68 | $18,986.84 | $28,689.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,963.28 / $26,963.28 / $26,963.28
| Facility | | $26,963.28 | $26,963.28 | $26,963.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,544.29 / $19,127.54 / $29,537.42
| Facility | | $16,544.29 | $19,127.54 | $29,537.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,318.57 / $49,695.40
| Facility | | $5,840.42 | $18,318.57 | $49,695.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,432.61 / $38,837.40
| Facility | | $5,840.42 | $14,432.61 | $38,837.40 |