- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,557.41 / $17,745.00 / $23,168.60
| Facility | | $8,557.41 | $17,745.00 | $23,168.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,204.83 / $43,393.35
| Facility | | $5,840.42 | $16,204.83 | $43,393.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,026.52 / $16,579.06 / $25,051.16
| Facility | | $10,026.52 | $16,579.06 | $25,051.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,543.98 / $23,543.98 / $23,543.98
| Facility | | $23,543.98 | $23,543.98 | $23,543.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,446.25 / $16,701.91 / $25,791.68
| Facility | | $14,446.25 | $16,701.91 | $25,791.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,204.83 / $43,393.35
| Facility | | $5,840.42 | $16,204.83 | $43,393.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,204.83 / $33,912.29
| Facility | | $5,840.42 | $16,204.83 | $33,912.29 |