- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,844.43 / $14,192.90 / $18,530.80
| Facility | | $6,844.43 | $14,192.90 | $18,530.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,793.61 / $34,707.05
| Facility | | $5,840.42 | $12,793.61 | $34,707.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,019.45 / $13,260.34 / $20,036.53
| Facility | | $8,019.45 | $13,260.34 | $20,036.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,831.04 / $18,831.04 / $18,831.04
| Facility | | $18,831.04 | $18,831.04 | $18,831.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,554.46 / $13,358.59 / $20,628.81
| Facility | | $11,554.46 | $13,358.59 | $20,628.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,793.61 / $34,707.05
| Facility | | $5,840.42 | $12,793.61 | $34,707.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,079.67 / $27,123.87
| Facility | | $5,840.42 | $10,079.67 | $27,123.87 |