- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,638.10 / $15,838.70 / $20,679.59
| Facility | | $7,638.10 | $15,838.70 | $20,679.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,463.96 / $38,731.66
| Facility | | $5,840.42 | $14,463.96 | $38,731.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,949.37 / $14,798.00 / $22,359.95
| Facility | | $8,949.37 | $14,798.00 | $22,359.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,014.68 / $21,014.68 / $21,014.68
| Facility | | $21,014.68 | $21,014.68 | $21,014.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,894.31 / $14,907.65 / $23,020.91
| Facility | | $12,894.31 | $14,907.65 | $23,020.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,463.96 / $38,731.66
| Facility | | $5,840.42 | $14,463.96 | $38,731.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,463.96 / $30,269.14
| Facility | | $5,840.42 | $14,463.96 | $30,269.14 |