- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $16,595.87 / $28,183.83
| Facility | | $8,128.31 | $16,595.87 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $15,135.61 / $40,738.03
| Facility | | $6,165.95 | $15,135.61 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $15,488.17 / $22,908.68
| Facility | | $10,232.93 | $15,488.17 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $23,442.29 / $23,442.29
| Facility | | $23,442.29 | $23,442.29 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $15,135.61 / $40,738.03
| Facility | | $6,165.95 | $15,135.61 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $15,135.61 / $40,738.03
| Facility | | $6,165.95 | $15,135.61 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,302.69 / $35,481.34
| Facility | | $6,165.95 | $12,302.69 | $35,481.34 |