- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,108.29 / $16,813.70 / $21,952.60
| Facility | | $8,108.29 | $16,813.70 | $21,952.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,156.02 / $41,115.91
| Facility | | $5,840.42 | $15,156.02 | $41,115.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,500.29 / $15,708.94 / $23,736.39
| Facility | | $9,500.29 | $15,708.94 | $23,736.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,308.30 / $22,308.30 / $22,308.30
| Facility | | $22,308.30 | $22,308.30 | $22,308.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,688.06 / $15,825.34 / $24,438.04
| Facility | | $13,688.06 | $15,825.34 | $24,438.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,156.02 / $41,115.91
| Facility | | $5,840.42 | $15,156.02 | $41,115.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,940.95 / $32,132.45
| Facility | | $5,840.42 | $11,940.95 | $32,132.45 |