- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,547.10 / $23,944.40 / $31,262.80
| Facility | | $11,547.10 | $23,944.40 | $31,262.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,866.19 / $58,553.37
| Facility | | $5,840.42 | $21,866.19 | $58,553.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,529.41 / $22,371.17 / $34,231.33
| Facility | | $13,529.41 | $22,371.17 | $34,231.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,769.36 / $31,769.36 / $31,769.36
| Facility | | $31,769.36 | $31,769.36 | $31,769.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,493.23 / $22,536.94 / $34,802.32
| Facility | | $19,493.23 | $22,536.94 | $34,802.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,866.19 / $58,553.37
| Facility | | $5,840.42 | $21,866.19 | $58,553.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,866.19 / $45,759.97
| Facility | | $5,840.42 | $21,866.19 | $45,759.97 |