- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,748.98 / $19,054.61
| Facility | | $8,317.64 | $11,748.98 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $17,378.01 / $17,378.01
| Facility | | $17,378.01 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,943.28 / $13,182.57
| Facility | | $3,890.45 | $7,943.28 | $13,182.57 |
- 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
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $11,481.54 / $19,054.61
| Facility | | $4,466.84 | $11,481.54 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,471.29 / $24,547.09
| Facility | | $7,244.36 | $10,471.29 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $9,772.37 / $22,387.21
| Facility | | $3,890.45 | $9,772.37 | $22,387.21 |