- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,756.20 / $24,378.10 / $31,829.10
| Facility | | $11,756.20 | $24,378.10 | $31,829.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,974.69 / $59,613.88
| Facility | | $5,840.42 | $21,974.69 | $59,613.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,774.45 / $22,776.35 / $34,415.33
| Facility | | $13,774.45 | $22,776.35 | $34,415.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,344.76 / $32,344.76 / $32,344.76
| Facility | | $32,344.76 | $32,344.76 | $32,344.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,846.29 / $22,945.12 / $35,432.66
| Facility | | $19,846.29 | $22,945.12 | $35,432.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,974.69 / $59,613.88
| Facility | | $5,840.42 | $21,974.69 | $59,613.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,313.15 / $46,588.78
| Facility | | $5,840.42 | $17,313.15 | $46,588.78 |