- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,923.78 / $18,504.70 / $24,160.50
| Facility | | $8,923.78 | $18,504.70 | $24,160.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,898.61 / $45,251.16
| Facility | | $5,840.42 | $16,898.61 | $45,251.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,455.78 / $17,288.87 / $26,123.68
| Facility | | $10,455.78 | $17,288.87 | $26,123.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,551.97 / $24,551.97 / $24,551.97
| Facility | | $24,551.97 | $24,551.97 | $24,551.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,064.74 / $17,416.97 / $26,895.90
| Facility | | $15,064.74 | $17,416.97 | $26,895.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,898.61 / $45,251.16
| Facility | | $5,840.42 | $16,898.61 | $45,251.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,898.61 / $35,364.18
| Facility | | $5,840.42 | $16,898.61 | $35,364.18 |