- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,174.29 / $19,024.20 / $24,838.80
| Facility | | $9,174.29 | $19,024.20 | $24,838.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,148.61 / $46,521.49
| Facility | | $5,840.42 | $17,148.61 | $46,521.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,749.31 / $17,774.21 / $26,857.05
| Facility | | $10,749.31 | $17,774.21 | $26,857.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,241.21 / $25,241.21 / $25,241.21
| Facility | | $25,241.21 | $25,241.21 | $25,241.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,487.65 / $17,905.91 / $27,650.94
| Facility | | $15,487.65 | $17,905.91 | $27,650.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,148.61 / $46,521.49
| Facility | | $5,840.42 | $17,148.61 | $46,521.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,510.84 / $36,356.94
| Facility | | $5,840.42 | $13,510.84 | $36,356.94 |