- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,090.04 / $18,849.50 / $24,610.70
| Facility | | $9,090.04 | $18,849.50 | $24,610.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,213.43 / $46,094.23
| Facility | | $5,840.42 | $17,213.43 | $46,094.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,650.58 / $17,610.97 / $26,610.39
| Facility | | $10,650.58 | $17,610.97 | $26,610.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,837.89 / $23,837.89 / $23,837.89
| Facility | | $23,837.89 | $23,837.89 | $23,837.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,345.41 / $17,741.47 / $27,396.99
| Facility | | $15,345.41 | $17,741.47 | $27,396.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,213.43 / $46,094.23
| Facility | | $5,840.42 | $17,213.43 | $46,094.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,213.43 / $36,023.05
| Facility | | $5,840.42 | $17,213.43 | $36,023.05 |