- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,549.52 / $13,581.40 / $17,732.40
| Facility | | $6,549.52 | $13,581.40 | $17,732.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,402.57 / $33,211.65
| Facility | | $5,840.42 | $12,402.57 | $33,211.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,673.92 / $12,689.00 / $19,173.22
| Facility | | $7,673.92 | $12,689.00 | $19,173.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,019.68 / $18,019.68 / $18,019.68
| Facility | | $18,019.68 | $18,019.68 | $18,019.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,056.62 / $12,783.02 / $19,739.98
| Facility | | $11,056.62 | $12,783.02 | $19,739.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,402.57 / $33,211.65
| Facility | | $5,840.42 | $12,402.57 | $33,211.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,402.57 / $25,955.20
| Facility | | $5,840.42 | $12,402.57 | $25,955.20 |