- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,206.80 / $25,312.60 / $33,049.10
| Facility | | $12,206.80 | $25,312.60 | $33,049.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,115.56 / $61,898.94
| Facility | | $5,840.42 | $23,115.56 | $61,898.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,302.44 / $23,649.40 / $35,734.51
| Facility | | $14,302.44 | $23,649.40 | $35,734.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,584.57 / $33,584.57 / $33,584.57
| Facility | | $33,584.57 | $33,584.57 | $33,584.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,607.02 / $23,824.64 / $36,790.83
| Facility | | $20,607.02 | $23,824.64 | $36,790.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,115.56 / $61,898.94
| Facility | | $5,840.42 | $23,115.56 | $61,898.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,115.56 / $48,374.57
| Facility | | $5,840.42 | $23,115.56 | $48,374.57 |