- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,225.84 / $14,983.80 / $19,563.50
| Facility | | $7,225.84 | $14,983.80 | $19,563.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,506.55 / $36,641.15
| Facility | | $5,840.42 | $13,506.55 | $36,641.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,466.35 / $13,999.29 / $21,153.09
| Facility | | $8,466.35 | $13,999.29 | $21,153.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,880.43 / $19,880.43 / $19,880.43
| Facility | | $19,880.43 | $19,880.43 | $19,880.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,198.35 / $14,103.02 / $21,778.38
| Facility | | $12,198.35 | $14,103.02 | $21,778.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,506.55 / $36,641.15
| Facility | | $5,840.42 | $13,506.55 | $36,641.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,641.38 / $28,635.39
| Facility | | $5,840.42 | $10,641.38 | $28,635.39 |