- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,467.52 / $13,411.30 / $17,510.40
| Facility | | $6,467.52 | $13,411.30 | $17,510.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,247.29 / $32,795.83
| Facility | | $5,840.42 | $12,247.29 | $32,795.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,577.84 / $12,530.13 / $18,933.16
| Facility | | $7,577.84 | $12,530.13 | $18,933.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,375.97 / $17,375.97 / $17,375.97
| Facility | | $17,375.97 | $17,375.97 | $17,375.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,918.19 / $12,622.98 / $19,492.84
| Facility | | $10,918.19 | $12,622.98 | $19,492.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,247.29 / $32,795.83
| Facility | | $5,840.42 | $12,247.29 | $32,795.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,247.29 / $25,630.24
| Facility | | $5,840.42 | $12,247.29 | $25,630.24 |