- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,261.95 / $15,058.70 / $19,661.20
| Facility | | $7,261.95 | $15,058.70 | $19,661.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,574.05 / $36,824.26
| Facility | | $5,840.42 | $13,574.05 | $36,824.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,508.66 / $14,069.25 / $21,258.80
| Facility | | $8,508.66 | $14,069.25 | $21,258.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,979.78 / $19,979.78 / $19,979.78
| Facility | | $19,979.78 | $19,979.78 | $19,979.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,259.31 / $14,173.50 / $21,887.21
| Facility | | $12,259.31 | $14,173.50 | $21,887.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,574.05 / $36,824.26
| Facility | | $5,840.42 | $13,574.05 | $36,824.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,694.56 / $28,778.49
| Facility | | $5,840.42 | $10,694.56 | $28,778.49 |