- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $15,488.17 / $23,988.33
| Facility | | $6,918.31 | $15,488.17 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,182.57 / $38,904.51
| Facility | | $6,165.95 | $13,182.57 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $13,803.84 / $20,892.96
| Facility | | $8,128.31 | $13,803.84 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $20,417.38 / $20,417.38
| Facility | | $20,417.38 | $20,417.38 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,182.57 / $38,904.51
| Facility | | $6,165.95 | $13,182.57 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,182.57 / $38,904.51
| Facility | | $6,165.95 | $13,182.57 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $10,964.78 / $35,481.34
| Facility | | $6,165.95 | $10,964.78 | $35,481.34 |