- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,666.88 / $13,824.70 / $18,050.09
| Facility | | $6,666.88 | $13,824.70 | $18,050.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,624.81 / $33,806.76
| Facility | | $5,840.42 | $12,624.81 | $33,806.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,811.43 / $12,916.37 / $19,516.78
| Facility | | $7,811.43 | $12,916.37 | $19,516.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,342.57 / $18,342.57 / $18,342.57
| Facility | | $18,342.57 | $18,342.57 | $18,342.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,254.74 / $13,012.07 / $20,093.70
| Facility | | $11,254.74 | $13,012.07 | $20,093.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,624.81 / $33,806.76
| Facility | | $5,840.42 | $12,624.81 | $33,806.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,624.81 / $26,420.28
| Facility | | $5,840.42 | $12,624.81 | $26,420.28 |