- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,950.11 / $18,559.30 / $24,231.80
| Facility | | $8,950.11 | $18,559.30 | $24,231.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,729.56 / $45,384.68
| Facility | | $5,840.42 | $16,729.56 | $45,384.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,486.63 / $17,339.88 / $26,200.76
| Facility | | $10,486.63 | $17,339.88 | $26,200.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,624.41 / $24,624.41 / $24,624.41
| Facility | | $24,624.41 | $24,624.41 | $24,624.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,109.19 / $17,468.37 / $26,975.26
| Facility | | $15,109.19 | $17,468.37 | $26,975.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,729.56 / $45,384.68
| Facility | | $5,840.42 | $16,729.56 | $45,384.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,180.69 / $35,468.53
| Facility | | $5,840.42 | $13,180.69 | $35,468.53 |