- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,509.27 / $17,645.20 / $23,038.20
| Facility | | $8,509.27 | $17,645.20 | $23,038.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,905.53 / $43,149.20
| Facility | | $5,840.42 | $15,905.53 | $43,149.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,970.10 / $16,485.78 / $24,910.22
| Facility | | $9,970.10 | $16,485.78 | $24,910.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,411.51 / $23,411.51 / $23,411.51
| Facility | | $23,411.51 | $23,411.51 | $23,411.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,364.97 / $16,607.93 / $25,646.56
| Facility | | $14,364.97 | $16,607.93 | $25,646.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,905.53 / $43,149.20
| Facility | | $5,840.42 | $15,905.53 | $43,149.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,531.46 / $33,721.48
| Facility | | $5,840.42 | $12,531.46 | $33,721.48 |