- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,481.54 / $18,620.87
| Facility | | $8,317.64 | $11,481.54 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $8,128.31 / $13,803.84
| Facility | | $3,981.07 | $8,128.31 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $12,022.64 / $22,387.21
| Facility | | $7,244.36 | $12,022.64 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $28,840.32 / $28,840.32
| Facility | | $28,840.32 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $11,481.54 / $18,620.87
| Facility | | $4,466.84 | $11,481.54 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,471.29 / $23,988.33
| Facility | | $7,244.36 | $10,471.29 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $9,772.37 / $21,877.62
| Facility | | $3,890.45 | $9,772.37 | $21,877.62 |