- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,719.54 / $13,933.90 / $18,192.70
| Facility | | $6,719.54 | $13,933.90 | $18,192.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,560.18 / $34,073.79
| Facility | | $5,840.42 | $12,560.18 | $34,073.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,873.13 / $13,018.39 / $19,670.93
| Facility | | $7,873.13 | $13,018.39 | $19,670.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,487.45 / $18,487.45 / $18,487.45
| Facility | | $18,487.45 | $18,487.45 | $18,487.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,343.64 / $13,114.86 / $20,252.41
| Facility | | $11,343.64 | $13,114.86 | $20,252.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,560.18 / $34,073.79
| Facility | | $5,840.42 | $12,560.18 | $34,073.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,895.76 / $26,628.97
| Facility | | $5,840.42 | $9,895.76 | $26,628.97 |