- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,680.98 / $15,927.60 / $20,795.70
| Facility | | $7,680.98 | $15,927.60 | $20,795.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,357.30 / $38,949.11
| Facility | | $5,840.42 | $14,357.30 | $38,949.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,999.62 / $14,881.08 / $22,485.48
| Facility | | $8,999.62 | $14,881.08 | $22,485.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,132.66 / $21,132.66 / $21,132.66
| Facility | | $21,132.66 | $21,132.66 | $21,132.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,966.70 / $14,991.34 / $23,150.15
| Facility | | $12,966.70 | $14,991.34 | $23,150.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,357.30 / $38,949.11
| Facility | | $5,840.42 | $14,357.30 | $38,949.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,311.66 / $30,439.07
| Facility | | $5,840.42 | $11,311.66 | $30,439.07 |