- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,365.02 / $15,272.40 / $19,940.30
| Facility | | $7,365.02 | $15,272.40 | $19,940.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,766.70 / $37,346.89
| Facility | | $5,840.42 | $13,766.70 | $37,346.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,629.42 / $14,268.93 / $21,560.52
| Facility | | $8,629.42 | $14,268.93 | $21,560.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,263.34 / $20,263.34 / $20,263.34
| Facility | | $20,263.34 | $20,263.34 | $20,263.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,433.30 / $14,374.66 / $22,197.85
| Facility | | $12,433.30 | $14,374.66 | $22,197.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,766.70 / $37,346.89
| Facility | | $5,840.42 | $13,766.70 | $37,346.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,846.34 / $29,186.93
| Facility | | $5,840.42 | $10,846.34 | $29,186.93 |