- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,860.60 / $26,668.20 / $34,819.10
| Facility | | $12,860.60 | $26,668.20 | $34,819.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,038.99 / $65,214.01
| Facility | | $5,840.42 | $24,038.99 | $65,214.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,068.42 / $24,915.96 / $37,648.32
| Facility | | $15,068.42 | $24,915.96 | $37,648.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,383.23 / $35,383.23 / $35,383.23
| Facility | | $35,383.23 | $35,383.23 | $35,383.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,710.65 / $25,100.59 / $38,761.19
| Facility | | $21,710.65 | $25,100.59 | $38,761.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,038.99 / $65,214.01
| Facility | | $5,840.42 | $24,038.99 | $65,214.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,939.55 / $50,965.32
| Facility | | $5,840.42 | $18,939.55 | $50,965.32 |