- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,270.03 / $17,149.09 / $22,390.50
| Facility | | $8,270.03 | $17,149.09 | $22,390.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,458.36 / $41,936.10
| Facility | | $5,840.42 | $15,458.36 | $41,936.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,689.79 / $16,022.30 / $24,209.88
| Facility | | $9,689.79 | $16,022.30 | $24,209.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,753.31 / $22,753.31 / $22,753.31
| Facility | | $22,753.31 | $22,753.31 | $22,753.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,961.11 / $16,141.02 / $24,925.53
| Facility | | $13,961.11 | $16,141.02 | $24,925.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,458.36 / $41,936.10
| Facility | | $5,840.42 | $15,458.36 | $41,936.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,179.14 / $32,773.43
| Facility | | $5,840.42 | $12,179.14 | $32,773.43 |