- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,601.24 / $15,762.20 / $20,579.80
| Facility | | $7,601.24 | $15,762.20 | $20,579.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,208.24 / $38,544.74
| Facility | | $5,840.42 | $14,208.24 | $38,544.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,906.19 / $14,726.58 / $22,252.04
| Facility | | $8,906.19 | $14,726.58 | $22,252.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,913.25 / $20,913.25 / $20,913.25
| Facility | | $20,913.25 | $20,913.25 | $20,913.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,832.08 / $14,835.70 / $22,909.81
| Facility | | $12,832.08 | $14,835.70 | $22,909.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,208.24 / $38,544.74
| Facility | | $5,840.42 | $14,208.24 | $38,544.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,194.22 / $30,123.06
| Facility | | $5,840.42 | $11,194.22 | $30,123.06 |