- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,524.30 / $25,970.90 / $33,908.60
| Facility | | $12,524.30 | $25,970.90 | $33,908.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,410.42 / $63,508.79
| Facility | | $5,840.42 | $23,410.42 | $63,508.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,674.41 / $24,264.46 / $36,663.89
| Facility | | $14,674.41 | $24,264.46 | $36,663.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,458.03 / $34,458.03 / $34,458.03
| Facility | | $34,458.03 | $34,458.03 | $34,458.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,142.96 / $24,444.26 / $37,747.68
| Facility | | $21,142.96 | $24,444.26 | $37,747.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,410.42 / $63,508.79
| Facility | | $5,840.42 | $23,410.42 | $63,508.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,444.32 / $49,632.68
| Facility | | $5,840.42 | $18,444.32 | $49,632.68 |