- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,954.82 / $16,495.40 / $21,537.10
| Facility | | $7,954.82 | $16,495.40 | $21,537.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,063.72 / $40,337.69
| Facility | | $5,840.42 | $15,063.72 | $40,337.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,320.46 / $15,411.61 / $23,287.12
| Facility | | $9,320.46 | $15,411.61 | $23,287.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,886.07 / $21,886.07 / $21,886.07
| Facility | | $21,886.07 | $21,886.07 | $21,886.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,428.98 / $15,525.80 / $23,975.49
| Facility | | $13,428.98 | $15,525.80 | $23,975.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,063.72 / $40,337.69
| Facility | | $5,840.42 | $15,063.72 | $40,337.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,063.72 / $31,524.27
| Facility | | $5,840.42 | $15,063.72 | $31,524.27 |