- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,273.04 / $17,155.30 / $22,398.70
| Facility | | $8,273.04 | $17,155.30 | $22,398.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,666.33 / $41,951.36
| Facility | | $5,840.42 | $15,666.33 | $41,951.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,693.33 / $16,028.13 / $24,218.69
| Facility | | $9,693.33 | $16,028.13 | $24,218.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,761.59 / $22,761.59 / $22,761.59
| Facility | | $22,761.59 | $22,761.59 | $22,761.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,966.19 / $16,146.90 / $24,934.60
| Facility | | $13,966.19 | $16,146.90 | $24,934.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,666.33 / $41,951.36
| Facility | | $5,840.42 | $15,666.33 | $41,951.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,666.33 / $32,785.36
| Facility | | $5,840.42 | $15,666.33 | $32,785.36 |