- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $14,791.08 / $24,547.09
| Facility | | $7,079.46 | $14,791.08 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,489.63 / $36,307.81
| Facility | | $6,165.95 | $13,489.63 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $19,952.62
| Facility | | $8,912.51 | $13,803.84 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $20,417.38 / $20,417.38
| Facility | | $20,417.38 | $20,417.38 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,182.57 / $36,307.81
| Facility | | $6,165.95 | $13,182.57 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,489.63 / $36,307.81
| Facility | | $6,165.95 | $13,489.63 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $10,964.78 / $30,902.95
| Facility | | $6,165.95 | $10,964.78 | $30,902.95 |