- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,751.51 / $18,147.50 / $23,694.10
| Facility | | $8,751.51 | $18,147.50 | $23,694.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,358.32 / $44,377.57
| Facility | | $5,840.42 | $16,358.32 | $44,377.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,253.93 / $16,955.09 / $25,619.36
| Facility | | $10,253.93 | $16,955.09 | $25,619.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,077.98 / $24,077.98 / $24,077.98
| Facility | | $24,077.98 | $24,077.98 | $24,077.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,773.91 / $17,080.73 / $26,376.66
| Facility | | $14,773.91 | $17,080.73 | $26,376.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,358.32 / $44,377.57
| Facility | | $5,840.42 | $16,358.32 | $44,377.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,888.20 / $34,681.46
| Facility | | $5,840.42 | $12,888.20 | $34,681.46 |