- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,756.97 / $16,085.20 / $21,001.40
| Facility | | $7,756.97 | $16,085.20 | $21,001.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,499.33 / $39,334.40
| Facility | | $5,840.42 | $14,499.33 | $39,334.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,088.65 / $15,028.28 / $22,707.92
| Facility | | $9,088.65 | $15,028.28 | $22,707.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,341.71 / $21,341.71 / $21,341.71
| Facility | | $21,341.71 | $21,341.71 | $21,341.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,094.97 / $15,139.64 / $23,379.16
| Facility | | $13,094.97 | $15,139.64 | $23,379.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,499.33 / $39,334.40
| Facility | | $5,840.42 | $14,499.33 | $39,334.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,423.56 / $30,740.18
| Facility | | $5,840.42 | $11,423.56 | $30,740.18 |