- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,081.77 / $18,832.30 / $24,588.30
| Facility | | $9,081.77 | $18,832.30 | $24,588.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,975.65 / $46,052.27
| Facility | | $5,840.42 | $16,975.65 | $46,052.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,640.89 / $17,594.93 / $26,586.17
| Facility | | $10,640.89 | $17,594.93 | $26,586.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,986.63 / $24,986.63 / $24,986.63
| Facility | | $24,986.63 | $24,986.63 | $24,986.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,331.44 / $17,725.32 / $27,372.05
| Facility | | $15,331.44 | $17,725.32 | $27,372.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,975.65 / $46,052.27
| Facility | | $5,840.42 | $16,975.65 | $46,052.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,374.57 / $35,990.25
| Facility | | $5,840.42 | $13,374.57 | $35,990.25 |