- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,696.03 / $15,958.80 / $20,836.50
| Facility | | $7,696.03 | $15,958.80 | $20,836.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,385.43 / $39,025.40
| Facility | | $5,840.42 | $14,385.43 | $39,025.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,017.25 / $14,910.23 / $22,529.53
| Facility | | $9,017.25 | $14,910.23 | $22,529.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,174.05 / $21,174.05 / $21,174.05
| Facility | | $21,174.05 | $21,174.05 | $21,174.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,992.10 / $15,020.71 / $23,195.50
| Facility | | $12,992.10 | $15,020.71 | $23,195.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,385.43 / $39,025.40
| Facility | | $5,840.42 | $14,385.43 | $39,025.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,333.82 / $30,498.70
| Facility | | $5,840.42 | $11,333.82 | $30,498.70 |