- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,330.41 / $15,200.60 / $19,846.59
| Facility | | $7,330.41 | $15,200.60 | $19,846.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,702.01 / $37,171.41
| Facility | | $5,840.42 | $13,702.01 | $37,171.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,588.87 / $14,201.88 / $21,459.21
| Facility | | $8,588.87 | $14,201.88 | $21,459.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,168.13 / $20,168.13 / $20,168.13
| Facility | | $20,168.13 | $20,168.13 | $20,168.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,374.88 / $14,307.12 / $22,093.55
| Facility | | $12,374.88 | $14,307.12 | $22,093.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,702.01 / $37,171.41
| Facility | | $5,840.42 | $13,702.01 | $37,171.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,795.38 / $29,049.79
| Facility | | $5,840.42 | $10,795.38 | $29,049.79 |