- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $30,199.52 / $50,118.72
| Facility | | $14,454.40 | $30,199.52 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $27,542.29 / $74,131.02
| Facility | | $6,165.95 | $27,542.29 | $74,131.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $28,840.32 / $43,651.58
| Facility | | $16,982.44 | $28,840.32 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,657.95 / $42,657.95 / $42,657.95
| Facility | | $42,657.95 | $42,657.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $27,542.29 / $74,131.02
| Facility | | $6,165.95 | $27,542.29 | $74,131.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $27,542.29 / $74,131.02
| Facility | | $6,165.95 | $27,542.29 | $74,131.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $22,387.21 / $64,565.42
| Facility | | $6,165.95 | $22,387.21 | $64,565.42 |