- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,678.17 / $13,848.10 / $18,080.70
| Facility | | $6,678.17 | $13,848.10 | $18,080.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,482.84 / $33,863.98
| Facility | | $5,840.42 | $12,482.84 | $33,863.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,824.65 / $12,938.23 / $19,549.82
| Facility | | $7,824.65 | $12,938.23 | $19,549.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,373.61 / $18,373.61 / $18,373.61
| Facility | | $18,373.61 | $18,373.61 | $18,373.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,273.79 / $13,034.10 / $20,127.71
| Facility | | $11,273.79 | $13,034.10 | $20,127.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,482.84 / $33,863.98
| Facility | | $5,840.42 | $12,482.84 | $33,863.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,834.83 / $26,465.00
| Facility | | $5,840.42 | $9,834.83 | $26,465.00 |