- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,021.58 / $18,707.50 / $24,425.30
| Facility | | $9,021.58 | $18,707.50 | $24,425.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,083.80 / $45,747.08
| Facility | | $5,840.42 | $17,083.80 | $45,747.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,570.37 / $17,478.34 / $26,409.98
| Facility | | $10,570.37 | $17,478.34 | $26,409.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,821.04 / $24,821.04 / $24,821.04
| Facility | | $24,821.04 | $24,821.04 | $24,821.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,229.84 / $17,607.84 / $27,190.66
| Facility | | $15,229.84 | $17,607.84 | $27,190.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,083.80 / $45,747.08
| Facility | | $5,840.42 | $17,083.80 | $45,747.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,083.80 / $35,751.75
| Facility | | $5,840.42 | $17,083.80 | $35,751.75 |