- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $18,620.87 / $30,902.95
| Facility | | $8,912.51 | $18,620.87 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,982.44 / $45,708.82
| Facility | | $6,165.95 | $16,982.44 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $17,782.79 / $26,302.68
| Facility | | $10,471.29 | $17,782.79 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $25,703.96 / $25,703.96
| Facility | | $25,703.96 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,595.87 / $45,708.82
| Facility | | $6,165.95 | $16,595.87 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,982.44 / $45,708.82
| Facility | | $6,165.95 | $16,982.44 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,803.84 / $39,810.72
| Facility | | $6,165.95 | $13,803.84 | $39,810.72 |