- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,623.61 / $17,882.30 / $23,347.80
| Facility | | $8,623.61 | $17,882.30 | $23,347.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,330.19 / $43,729.05
| Facility | | $5,840.42 | $16,330.19 | $43,729.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,104.08 / $16,707.32 / $25,244.96
| Facility | | $10,104.08 | $16,707.32 | $25,244.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,726.12 / $23,726.12 / $23,726.12
| Facility | | $23,726.12 | $23,726.12 | $23,726.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,558.01 / $16,831.12 / $25,991.21
| Facility | | $14,558.01 | $16,831.12 | $25,991.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,330.19 / $43,729.05
| Facility | | $5,840.42 | $16,330.19 | $43,729.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,330.19 / $34,174.64
| Facility | | $5,840.42 | $16,330.19 | $34,174.64 |