- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $15,488.17 / $25,118.86
| Facility | | $10,232.93 | $15,488.17 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $18,620.87 / $20,417.38
| Facility | | $4,897.79 | $18,620.87 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $22,908.68 / $32,359.37
| Facility | | $9,772.37 | $22,908.68 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $13,803.84 / $25,118.86
| Facility | | $5,888.44 | $13,803.84 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $11,481.54 / $32,359.37
| Facility | | $9,772.37 | $11,481.54 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $12,882.50 / $29,512.09
| Facility | | $5,128.61 | $12,882.50 | $29,512.09 |