- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,929.20 / $33,031.40 / $43,127.20
| Facility | | $15,929.20 | $33,031.40 | $43,127.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,774.88 / $80,774.58
| Facility | | $5,840.42 | $29,774.88 | $80,774.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,663.86 / $30,861.11 / $46,631.50
| Facility | | $18,663.86 | $30,861.11 | $46,631.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,825.95 / $43,825.95 / $43,825.95
| Facility | | $43,825.95 | $43,825.95 | $43,825.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,890.98 / $31,089.78 / $48,009.93
| Facility | | $26,890.98 | $31,089.78 | $48,009.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,774.88 / $80,774.58
| Facility | | $5,840.42 | $29,774.88 | $80,774.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,458.67 / $63,126.05
| Facility | | $5,840.42 | $23,458.67 | $63,126.05 |