- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $16,982.44 / $28,840.32
| Facility | | $8,317.64 | $16,982.44 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $15,488.17 / $41,686.94
| Facility | | $6,165.95 | $15,488.17 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $16,218.10 / $24,547.09
| Facility | | $9,772.37 | $16,218.10 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $23,988.33
| Facility | | $23,988.33 | $23,988.33 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $15,488.17 / $41,686.94
| Facility | | $6,165.95 | $15,488.17 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $15,488.17 / $41,686.94
| Facility | | $6,165.95 | $15,488.17 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,589.25 / $36,307.81
| Facility | | $6,165.95 | $12,589.25 | $36,307.81 |