- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,915.50 / $26,782.10 / $34,967.80
| Facility | | $12,915.50 | $26,782.10 | $34,967.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,141.64 / $65,492.49
| Facility | | $5,840.42 | $24,141.64 | $65,492.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,132.77 / $25,022.36 / $37,809.08
| Facility | | $15,132.77 | $25,022.36 | $37,809.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,534.33 / $35,534.33 / $35,534.33
| Facility | | $35,534.33 | $35,534.33 | $35,534.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,803.36 / $25,207.77 / $38,926.72
| Facility | | $21,803.36 | $25,207.77 | $38,926.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,141.64 / $65,492.49
| Facility | | $5,840.42 | $24,141.64 | $65,492.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,020.43 / $51,182.96
| Facility | | $5,840.42 | $19,020.43 | $51,182.96 |