- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,039.27 / $14,596.90 / $19,058.30
| Facility | | $7,039.27 | $14,596.90 | $19,058.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,157.81 / $35,695.08
| Facility | | $5,840.42 | $13,157.81 | $35,695.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,247.75 / $13,637.83 / $20,606.91
| Facility | | $8,247.75 | $13,637.83 | $20,606.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,367.12 / $19,367.12 / $19,367.12
| Facility | | $19,367.12 | $19,367.12 | $19,367.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,883.39 / $13,738.88 / $21,216.06
| Facility | | $11,883.39 | $13,738.88 | $21,216.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,157.81 / $35,695.08
| Facility | | $5,840.42 | $13,157.81 | $35,695.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,366.62 / $27,896.02
| Facility | | $5,840.42 | $10,366.62 | $27,896.02 |