- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,377.81 / $15,298.90 / $19,974.90
| Facility | | $7,377.81 | $15,298.90 | $19,974.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,790.60 / $37,411.74
| Facility | | $5,840.42 | $13,790.60 | $37,411.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,644.40 / $14,293.70 / $21,597.96
| Facility | | $8,644.40 | $14,293.70 | $21,597.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,298.53 / $20,298.53 / $20,298.53
| Facility | | $20,298.53 | $20,298.53 | $20,298.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,454.89 / $14,399.62 / $22,236.39
| Facility | | $12,454.89 | $14,399.62 | $22,236.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,790.60 / $37,411.74
| Facility | | $5,840.42 | $13,790.60 | $37,411.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,865.18 / $29,237.61
| Facility | | $5,840.42 | $10,865.18 | $29,237.61 |