- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,658.03 / $20,027.30 / $26,148.40
| Facility | | $9,658.03 | $20,027.30 | $26,148.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,052.80 / $48,974.40
| Facility | | $5,840.42 | $18,052.80 | $48,974.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,316.08 / $18,711.39 / $28,273.13
| Facility | | $11,316.08 | $18,711.39 | $28,273.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,572.09 / $26,572.09 / $26,572.09
| Facility | | $26,572.09 | $26,572.09 | $26,572.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,304.26 / $18,850.04 / $29,108.88
| Facility | | $16,304.26 | $18,850.04 | $29,108.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,052.80 / $48,974.40
| Facility | | $5,840.42 | $18,052.80 | $48,974.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,223.22 / $38,273.93
| Facility | | $5,840.42 | $14,223.22 | $38,273.93 |