- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,246.91 / $15,027.50 / $19,620.50
| Facility | | $7,246.91 | $15,027.50 | $19,620.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,545.92 / $36,747.97
| Facility | | $5,840.42 | $13,545.92 | $36,747.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,491.03 / $14,040.10 / $21,214.76
| Facility | | $8,491.03 | $14,040.10 | $21,214.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,938.38 / $19,938.38 / $19,938.38
| Facility | | $19,938.38 | $19,938.38 | $19,938.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,233.91 / $14,144.13 / $21,841.86
| Facility | | $12,233.91 | $14,144.13 | $21,841.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,545.92 / $36,747.97
| Facility | | $5,840.42 | $13,545.92 | $36,747.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,672.40 / $28,718.86
| Facility | | $5,840.42 | $10,672.40 | $28,718.86 |