- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,953.51 / $14,419.10 / $18,826.09
| Facility | | $6,953.51 | $14,419.10 | $18,826.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,997.51 / $35,260.19
| Facility | | $5,840.42 | $12,997.51 | $35,260.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,147.26 / $13,471.67 / $20,355.86
| Facility | | $8,147.26 | $13,471.67 | $20,355.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,131.16 / $19,131.16 / $19,131.16
| Facility | | $19,131.16 | $19,131.16 | $19,131.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,738.61 / $13,571.50 / $20,957.58
| Facility | | $11,738.61 | $13,571.50 | $20,957.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,997.51 / $35,260.19
| Facility | | $5,840.42 | $12,997.51 | $35,260.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,240.32 / $27,556.16
| Facility | | $5,840.42 | $10,240.32 | $27,556.16 |