- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,656.16 / $15,876.10 / $20,728.50
| Facility | | $7,656.16 | $15,876.10 | $20,728.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,310.90 / $38,823.22
| Facility | | $5,840.42 | $14,310.90 | $38,823.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,970.54 / $14,832.98 / $22,412.81
| Facility | | $8,970.54 | $14,832.98 | $22,412.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,064.35 / $21,064.35 / $21,064.35
| Facility | | $21,064.35 | $21,064.35 | $21,064.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,924.79 / $14,942.89 / $23,075.33
| Facility | | $12,924.79 | $14,942.89 | $23,075.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,310.90 / $38,823.22
| Facility | | $5,840.42 | $14,310.90 | $38,823.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,275.10 / $30,340.69
| Facility | | $5,840.42 | $11,275.10 | $30,340.69 |