- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,943.15 / $20,618.50 / $26,920.40
| Facility | | $9,943.15 | $20,618.50 | $26,920.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,828.93 / $50,420.21
| Facility | | $5,840.42 | $18,828.93 | $50,420.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,650.15 / $19,263.78 / $29,107.80
| Facility | | $11,650.15 | $19,263.78 | $29,107.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,356.55 / $27,356.55 / $27,356.55
| Facility | | $27,356.55 | $27,356.55 | $27,356.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,785.59 / $19,406.52 / $29,968.23
| Facility | | $16,785.59 | $19,406.52 | $29,968.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,828.93 / $50,420.21
| Facility | | $5,840.42 | $18,828.93 | $50,420.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,828.93 / $39,403.83
| Facility | | $5,840.42 | $18,828.93 | $39,403.83 |