- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,952.37 / $18,564.00 / $24,237.90
| Facility | | $8,952.37 | $18,564.00 | $24,237.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,733.78 / $45,396.12
| Facility | | $5,840.42 | $16,733.78 | $45,396.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,489.28 / $17,344.25 / $26,207.37
| Facility | | $10,489.28 | $17,344.25 | $26,207.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,630.62 / $24,630.62 / $24,630.62
| Facility | | $24,630.62 | $24,630.62 | $24,630.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,113.00 / $17,472.77 / $26,982.06
| Facility | | $15,113.00 | $17,472.77 | $26,982.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,733.78 / $45,396.12
| Facility | | $5,840.42 | $16,733.78 | $45,396.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,184.01 / $35,477.47
| Facility | | $5,840.42 | $13,184.01 | $35,477.47 |