- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $13,182.57 / $21,379.62
| Facility | | $8,709.64 | $13,182.57 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $18,197.01 / $21,877.62
| Facility | | $16,982.44 | $18,197.01 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $8,709.64 / $14,791.08
| Facility | | $4,073.80 | $8,709.64 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $13,489.63 / $25,118.86
| Facility | | $8,128.31 | $13,489.63 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,359.37 / $32,359.37 / $32,359.37
| Facility | | $32,359.37 | $32,359.37 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $12,302.69 / $21,379.62
| Facility | | $5,011.87 | $12,302.69 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $11,481.54 / $27,542.29
| Facility | | $8,128.31 | $11,481.54 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $10,964.78 / $25,118.86
| Facility | | $4,365.16 | $10,964.78 | $25,118.86 |