- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,540.30 / $15,635.90 / $20,414.80
| Facility | | $7,540.30 | $15,635.90 | $20,414.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,094.34 / $38,235.74
| Facility | | $5,840.42 | $14,094.34 | $38,235.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,834.79 / $14,608.52 / $22,073.65
| Facility | | $8,834.79 | $14,608.52 | $22,073.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,745.61 / $20,745.61 / $20,745.61
| Facility | | $20,745.61 | $20,745.61 | $20,745.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,729.21 / $14,716.77 / $22,726.15
| Facility | | $12,729.21 | $14,716.77 | $22,726.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,094.34 / $38,235.74
| Facility | | $5,840.42 | $14,094.34 | $38,235.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,104.48 / $29,881.57
| Facility | | $5,840.42 | $11,104.48 | $29,881.57 |