- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,302.69 / $19,952.62
| Facility | | $8,128.31 | $12,302.69 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $14,454.40 / $16,595.87
| Facility | | $8,128.31 | $14,454.40 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $8,128.31 / $14,125.38
| Facility | | $3,801.89 | $8,128.31 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,589.25 / $23,988.33
| Facility | | $7,762.47 | $12,589.25 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $30,902.95 / $30,902.95
| Facility | | $30,902.95 | $30,902.95 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $11,481.54 / $19,952.62
| Facility | | $4,677.35 | $11,481.54 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $11,220.18 / $25,703.96
| Facility | | $7,585.78 | $11,220.18 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $10,471.29 / $23,442.29
| Facility | | $4,073.80 | $10,471.29 | $23,442.29 |