- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,736.85 / $13,969.80 / $18,239.50
| Facility | | $6,736.85 | $13,969.80 | $18,239.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,592.52 / $34,161.53
| Facility | | $5,840.42 | $12,592.52 | $34,161.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,893.40 / $13,051.91 / $19,721.59
| Facility | | $7,893.40 | $13,051.91 | $19,721.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,535.06 / $18,535.06 / $18,535.06
| Facility | | $18,535.06 | $18,535.06 | $18,535.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,372.85 / $13,148.63 / $20,304.57
| Facility | | $11,372.85 | $13,148.63 | $20,304.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,592.52 / $34,161.53
| Facility | | $5,840.42 | $12,592.52 | $34,161.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,921.24 / $26,697.54
| Facility | | $5,840.42 | $9,921.24 | $26,697.54 |