- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,488.17 / $25,118.86
| Facility | | $10,964.78 | $15,488.17 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $19,054.61 / $40,738.03
| Facility | | $18,197.01 | $19,054.61 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $10,964.78 / $18,620.87
| Facility | | $5,623.41 | $10,964.78 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $16,218.10 / $29,512.09
| Facility | | $9,772.37 | $16,218.10 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $15,488.17 / $25,118.86
| Facility | | $6,025.60 | $15,488.17 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $14,125.38 / $32,359.37
| Facility | | $9,772.37 | $14,125.38 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $13,182.57 / $29,512.09
| Facility | | $5,248.07 | $13,182.57 | $29,512.09 |