- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,161.70 / $16,924.40 / $22,097.20
| Facility | | $8,161.70 | $16,924.40 | $22,097.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,455.49 / $41,386.76
| Facility | | $5,840.42 | $15,455.49 | $41,386.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,562.87 / $15,812.42 / $23,892.75
| Facility | | $9,562.87 | $15,812.42 | $23,892.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,455.26 / $22,455.26 / $22,455.26
| Facility | | $22,455.26 | $22,455.26 | $22,455.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,778.23 / $15,929.59 / $24,599.02
| Facility | | $13,778.23 | $15,929.59 | $24,599.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,455.49 / $41,386.76
| Facility | | $5,840.42 | $15,455.49 | $41,386.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,455.49 / $32,344.12
| Facility | | $5,840.42 | $15,455.49 | $32,344.12 |