- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,835.96 / $16,249.00 / $21,215.30
| Facility | | $7,835.96 | $16,249.00 | $21,215.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,646.98 / $39,734.96
| Facility | | $5,840.42 | $14,646.98 | $39,734.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,181.20 / $15,181.32 / $22,939.16
| Facility | | $9,181.20 | $15,181.32 | $22,939.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,559.04 / $21,559.04 / $21,559.04
| Facility | | $21,559.04 | $21,559.04 | $21,559.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,228.32 / $15,293.81 / $23,617.24
| Facility | | $13,228.32 | $15,293.81 | $23,617.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,646.98 / $39,734.96
| Facility | | $5,840.42 | $14,646.98 | $39,734.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,539.89 / $31,053.22
| Facility | | $5,840.42 | $11,539.89 | $31,053.22 |