- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,888.23 / $20,504.59 / $26,771.70
| Facility | | $9,888.23 | $20,504.59 | $26,771.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,483.09 / $50,141.73
| Facility | | $5,840.42 | $18,483.09 | $50,141.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,585.81 / $19,157.38 / $28,947.03
| Facility | | $11,585.81 | $19,157.38 | $28,947.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,205.45 / $27,205.45 / $27,205.45
| Facility | | $27,205.45 | $27,205.45 | $27,205.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,692.88 / $19,299.34 / $29,802.71
| Facility | | $16,692.88 | $19,299.34 | $29,802.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,483.09 / $50,141.73
| Facility | | $5,840.42 | $18,483.09 | $50,141.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,562.24 / $39,186.21
| Facility | | $5,840.42 | $14,562.24 | $39,186.21 |