- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,602.30 / $28,206.40 / $36,827.40
| Facility | | $13,602.30 | $28,206.40 | $36,827.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,758.19 / $68,975.39
| Facility | | $5,840.42 | $25,758.19 | $68,975.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,937.53 / $26,353.06 / $39,819.79
| Facility | | $15,937.53 | $26,353.06 | $39,819.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,424.05 / $37,424.05 / $37,424.05
| Facility | | $37,424.05 | $37,424.05 | $37,424.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,962.87 / $26,548.33 / $40,996.86
| Facility | | $22,962.87 | $26,548.33 | $40,996.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,758.19 / $68,975.39
| Facility | | $5,840.42 | $25,758.19 | $68,975.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,758.19 / $53,904.89
| Facility | | $5,840.42 | $25,758.19 | $53,904.89 |