- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,596.53 / $17,826.09 / $23,274.50
| Facility | | $8,596.53 | $17,826.09 | $23,274.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,068.65 / $43,591.72
| Facility | | $5,840.42 | $16,068.65 | $43,591.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,072.35 / $16,654.84 / $25,165.68
| Facility | | $10,072.35 | $16,654.84 | $25,165.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,651.60 / $23,651.60 / $23,651.60
| Facility | | $23,651.60 | $23,651.60 | $23,651.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,512.29 / $16,778.25 / $25,909.58
| Facility | | $14,512.29 | $16,778.25 | $25,909.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,068.65 / $43,591.72
| Facility | | $5,840.42 | $16,068.65 | $43,591.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,659.97 / $34,067.32
| Facility | | $5,840.42 | $12,659.97 | $34,067.32 |