- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.52 / $16,969.70 / $22,156.30
| Facility | | $8,183.52 | $16,969.70 | $22,156.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,296.64 / $41,497.39
| Facility | | $5,840.42 | $15,296.64 | $41,497.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,588.43 / $15,854.69 / $23,956.62
| Facility | | $9,588.43 | $15,854.69 | $23,956.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,515.28 / $22,515.28 / $22,515.28
| Facility | | $22,515.28 | $22,515.28 | $22,515.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,815.06 / $15,972.17 / $24,664.78
| Facility | | $13,815.06 | $15,972.17 | $24,664.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,296.64 / $41,497.39
| Facility | | $5,840.42 | $15,296.64 | $41,497.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,051.74 / $32,430.58
| Facility | | $5,840.42 | $12,051.74 | $32,430.58 |