- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,798.90 / $18,245.80 / $23,822.40
| Facility | | $8,798.90 | $18,245.80 | $23,822.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,662.12 / $44,617.90
| Facility | | $5,840.42 | $16,662.12 | $44,617.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,309.45 / $17,046.91 / $25,758.10
| Facility | | $10,309.45 | $17,046.91 | $25,758.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,208.38 / $24,208.38 / $24,208.38
| Facility | | $24,208.38 | $24,208.38 | $24,208.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,853.92 / $17,173.24 / $26,519.51
| Facility | | $14,853.92 | $17,173.24 | $26,519.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,662.12 / $44,617.90
| Facility | | $5,840.42 | $16,662.12 | $44,617.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,662.12 / $34,869.28
| Facility | | $5,840.42 | $16,662.12 | $34,869.28 |