- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,881.29 / $14,269.30 / $18,630.59
| Facility | | $6,881.29 | $14,269.30 | $18,630.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,862.51 / $34,893.98
| Facility | | $5,840.42 | $12,862.51 | $34,893.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,062.64 / $13,331.75 / $20,144.43
| Facility | | $8,062.64 | $13,331.75 | $20,144.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,932.46 / $18,932.46 / $18,932.46
| Facility | | $18,932.46 | $18,932.46 | $18,932.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,616.69 / $13,430.54 / $20,739.91
| Facility | | $11,616.69 | $13,430.54 | $20,739.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,862.51 / $34,893.98
| Facility | | $5,840.42 | $12,862.51 | $34,893.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,133.95 / $27,269.95
| Facility | | $5,840.42 | $10,133.95 | $27,269.95 |