- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,219.40 / $27,412.30 / $35,790.60
| Facility | | $13,219.40 | $27,412.30 | $35,790.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,709.75 / $67,033.67
| Facility | | $5,840.42 | $24,709.75 | $67,033.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.87 / $25,611.19 / $38,698.82
| Facility | | $15,488.87 | $25,611.19 | $38,698.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,370.53 / $36,370.53 / $36,370.53
| Facility | | $36,370.53 | $36,370.53 | $36,370.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,316.44 / $25,800.97 / $39,842.75
| Facility | | $22,316.44 | $25,800.97 | $39,842.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,709.75 / $67,033.67
| Facility | | $5,840.42 | $24,709.75 | $67,033.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,468.02 / $52,387.40
| Facility | | $5,840.42 | $19,468.02 | $52,387.40 |