- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,306.34 / $15,150.70 / $19,781.40
| Facility | | $7,306.34 | $15,150.70 | $19,781.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,657.01 / $37,049.33
| Facility | | $5,840.42 | $13,657.01 | $37,049.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,560.66 / $14,155.24 / $21,388.74
| Facility | | $8,560.66 | $14,155.24 | $21,388.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,101.90 / $20,101.90 / $20,101.90
| Facility | | $20,101.90 | $20,101.90 | $20,101.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,334.24 / $14,260.13 / $22,020.99
| Facility | | $12,334.24 | $14,260.13 | $22,020.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,657.01 / $37,049.33
| Facility | | $5,840.42 | $13,657.01 | $37,049.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,657.01 / $32,245.78
| Facility | | $3,775.00 | $13,657.01 | $32,245.78 |