- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $18,197.01 / $30,199.52
| Facility | | $8,709.64 | $18,197.01 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,595.87 / $44,668.36
| Facility | | $6,165.95 | $16,595.87 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $17,378.01 / $26,302.68
| Facility | | $10,232.93 | $17,378.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $25,703.96 / $25,703.96
| Facility | | $25,703.96 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,595.87 / $44,668.36
| Facility | | $6,165.95 | $16,595.87 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,595.87 / $44,668.36
| Facility | | $6,165.95 | $16,595.87 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,489.63 / $38,904.51
| Facility | | $6,165.95 | $13,489.63 | $38,904.51 |