- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,223.58 / $14,979.10 / $19,557.40
| Facility | | $7,223.58 | $14,979.10 | $19,557.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,502.33 / $36,629.71
| Facility | | $5,840.42 | $13,502.33 | $36,629.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,103.66 / $13,299.73 / $19,403.72
| Facility | | $9,103.66 | $13,299.73 | $19,403.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,874.22 / $19,874.22 / $19,874.22
| Facility | | $19,874.22 | $19,874.22 | $19,874.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,194.54 / $14,098.62 / $21,771.57
| Facility | | $12,194.54 | $14,098.62 | $21,771.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,502.33 / $36,629.71
| Facility | | $5,840.42 | $13,502.33 | $36,629.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,638.06 / $28,626.44
| Facility | | $5,840.42 | $10,638.06 | $28,626.44 |