- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,414.79 / $21,596.60 / $28,197.50
| Facility | | $10,414.79 | $21,596.60 | $28,197.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,722.16 / $52,812.09
| Facility | | $5,840.42 | $19,722.16 | $52,812.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,202.82 / $20,177.63 / $30,488.64
| Facility | | $12,202.82 | $20,177.63 | $30,488.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,654.31 / $28,654.31 / $28,654.31
| Facility | | $28,654.31 | $28,654.31 | $28,654.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,581.88 / $20,327.15 / $31,389.89
| Facility | | $17,581.88 | $20,327.15 | $31,389.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,722.16 / $52,812.09
| Facility | | $5,840.42 | $19,722.16 | $52,812.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,722.16 / $41,273.12
| Facility | | $5,840.42 | $19,722.16 | $41,273.12 |