- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,943.90 / $20,620.09 / $26,922.40
| Facility | | $9,943.90 | $20,620.09 | $26,922.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,587.15 / $50,424.03
| Facility | | $5,840.42 | $18,587.15 | $50,424.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,651.03 / $19,265.24 / $29,110.00
| Facility | | $11,651.03 | $19,265.24 | $29,110.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,358.62 / $27,358.62 / $27,358.62
| Facility | | $27,358.62 | $27,358.62 | $27,358.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,786.86 / $19,407.99 / $29,970.49
| Facility | | $16,786.86 | $19,407.99 | $29,970.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,587.15 / $50,424.03
| Facility | | $5,840.42 | $18,587.15 | $50,424.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,644.22 / $39,406.82
| Facility | | $5,840.42 | $14,644.22 | $39,406.82 |