- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $24,547.09 / $40,738.03
| Facility | | $11,748.98 | $24,547.09 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $22,387.21 / $58,884.37
| Facility | | $6,165.95 | $22,387.21 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $23,442.29 / $34,673.69
| Facility | | $13,803.84 | $23,442.29 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,884.42 / $33,884.42 / $33,884.42
| Facility | | $33,884.42 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $21,877.62 / $58,884.37
| Facility | | $6,165.95 | $21,877.62 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $22,387.21 / $58,884.37
| Facility | | $6,165.95 | $22,387.21 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $17,782.79 / $51,286.14
| Facility | | $6,165.95 | $17,782.79 | $51,286.14 |