- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.70 / $19,802.59 / $25,855.10
| Facility | | $9,549.70 | $19,802.59 | $25,855.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,850.30 / $48,425.07
| Facility | | $5,840.42 | $17,850.30 | $48,425.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,189.15 / $18,501.50 / $27,956.00
| Facility | | $11,189.15 | $18,501.50 | $27,956.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,274.04 / $26,274.04 / $26,274.04
| Facility | | $26,274.04 | $26,274.04 | $26,274.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,121.38 / $18,638.59 / $28,782.38
| Facility | | $16,121.38 | $18,638.59 | $28,782.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,850.30 / $48,425.07
| Facility | | $5,840.42 | $17,850.30 | $48,425.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,063.68 / $37,844.62
| Facility | | $5,840.42 | $14,063.68 | $37,844.62 |