- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,997.50 / $26,952.10 / $35,189.80
| Facility | | $12,997.50 | $26,952.10 | $35,189.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,612.81 / $65,908.30
| Facility | | $5,840.42 | $24,612.81 | $65,908.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,228.85 / $25,181.23 / $38,049.14
| Facility | | $15,228.85 | $25,181.23 | $38,049.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,759.93 / $35,759.93 / $35,759.93
| Facility | | $35,759.93 | $35,759.93 | $35,759.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,941.79 / $25,367.82 / $39,173.87
| Facility | | $21,941.79 | $25,367.82 | $39,173.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,612.81 / $65,908.30
| Facility | | $5,840.42 | $24,612.81 | $65,908.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,612.81 / $51,507.92
| Facility | | $5,840.42 | $24,612.81 | $51,507.92 |