- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,264.77 / $17,138.20 / $22,376.30
| Facility | | $8,264.77 | $17,138.20 | $22,376.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,448.51 / $41,909.39
| Facility | | $5,840.42 | $15,448.51 | $41,909.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,683.62 / $16,012.10 / $24,194.47
| Facility | | $9,683.62 | $16,012.10 | $24,194.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,738.82 / $22,738.82 / $22,738.82
| Facility | | $22,738.82 | $22,738.82 | $22,738.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,952.22 / $16,130.74 / $24,909.66
| Facility | | $13,952.22 | $16,130.74 | $24,909.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,448.51 / $41,909.39
| Facility | | $5,840.42 | $15,448.51 | $41,909.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,171.39 / $32,752.56
| Facility | | $5,840.42 | $12,171.39 | $32,752.56 |