- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $8,317.64 / $22,908.68
| Facility | | $5,370.32 | $8,317.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,630.27 / $14,454.40
| Facility | | $2,630.27 | $2,630.27 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $20,892.96 / $32,359.37
| Facility | | $14,454.40 | $20,892.96 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,220.18 / $15,135.61
| Facility | | $7,244.36 | $11,220.18 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,977.88 / $48,977.88 / $48,977.88
| Facility | | $48,977.88 | $48,977.88 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $12,589.25 / $18,197.01
| Facility | | $3,801.89 | $12,589.25 | $18,197.01 |