- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,009.70 / $24,903.80 / $32,515.50
| Facility | | $12,009.70 | $24,903.80 | $32,515.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,742.31 / $60,899.47
| Facility | | $5,840.42 | $22,742.31 | $60,899.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,071.50 / $23,267.53 / $35,157.51
| Facility | | $14,071.50 | $23,267.53 | $35,157.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,042.29 / $33,042.29 / $33,042.29
| Facility | | $33,042.29 | $33,042.29 | $33,042.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,274.28 / $23,439.94 / $36,196.76
| Facility | | $20,274.28 | $23,439.94 | $36,196.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,742.31 / $60,899.47
| Facility | | $5,840.42 | $22,742.31 | $60,899.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,742.31 / $47,593.47
| Facility | | $5,840.42 | $22,742.31 | $47,593.47 |