- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,233.17 / $17,072.59 / $22,290.70
| Facility | | $8,233.17 | $17,072.59 | $22,290.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,389.45 / $41,749.17
| Facility | | $5,840.42 | $15,389.45 | $41,749.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,646.61 / $15,950.88 / $24,101.97
| Facility | | $9,646.61 | $15,950.88 | $24,101.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,651.89 / $22,651.89 / $22,651.89
| Facility | | $22,651.89 | $22,651.89 | $22,651.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,898.88 / $16,069.08 / $24,814.43
| Facility | | $13,898.88 | $16,069.08 | $24,814.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,389.45 / $41,749.17
| Facility | | $5,840.42 | $15,389.45 | $41,749.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,124.86 / $32,627.35
| Facility | | $5,840.42 | $12,124.86 | $32,627.35 |