- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,342.45 / $15,225.60 / $19,879.20
| Facility | | $7,342.45 | $15,225.60 | $19,879.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,724.51 / $37,232.44
| Facility | | $5,840.42 | $13,724.51 | $37,232.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,602.96 / $14,225.20 / $21,494.45
| Facility | | $8,602.96 | $14,225.20 | $21,494.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,201.25 / $20,201.25 / $20,201.25
| Facility | | $20,201.25 | $20,201.25 | $20,201.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,395.20 / $14,330.61 / $22,129.82
| Facility | | $12,395.20 | $14,330.61 | $22,129.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,724.51 / $37,232.44
| Facility | | $5,840.42 | $13,724.51 | $37,232.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,813.10 / $29,097.49
| Facility | | $5,840.42 | $10,813.10 | $29,097.49 |