- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,718.80 / $22,226.90 / $29,020.30
| Facility | | $10,718.80 | $22,226.90 | $29,020.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,035.54 / $54,353.27
| Facility | | $5,840.42 | $20,035.54 | $54,353.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,558.93 / $20,766.46 / $31,378.37
| Facility | | $12,558.93 | $20,766.46 | $31,378.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,490.51 / $29,490.51 / $29,490.51
| Facility | | $29,490.51 | $29,490.51 | $29,490.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,094.96 / $20,920.34 / $32,305.92
| Facility | | $18,094.96 | $20,920.34 | $32,305.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,035.54 / $54,353.27
| Facility | | $5,840.42 | $20,035.54 | $54,353.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,785.36 / $42,477.56
| Facility | | $5,840.42 | $15,785.36 | $42,477.56 |