- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $15,848.93 / $26,302.68
| Facility | | $7,585.78 | $15,848.93 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $14,454.40 / $38,904.51
| Facility | | $6,165.95 | $14,454.40 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $15,135.61 / $22,387.21
| Facility | | $8,912.51 | $15,135.61 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $21,877.62 / $21,877.62
| Facility | | $21,877.62 | $21,877.62 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $14,125.38 / $38,904.51
| Facility | | $6,165.95 | $14,125.38 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $14,454.40 / $38,904.51
| Facility | | $6,165.95 | $14,454.40 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $11,748.98 / $33,884.42
| Facility | | $6,165.95 | $11,748.98 | $33,884.42 |