- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,403.70 / $27,794.50 / $36,289.69
| Facility | | $13,403.70 | $27,794.50 | $36,289.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,382.10 / $67,968.28
| Facility | | $5,840.42 | $25,382.10 | $67,968.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,704.83 / $25,968.28 / $39,735.47
| Facility | | $15,704.83 | $25,968.28 | $39,735.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,877.62 / $36,877.62 / $36,877.62
| Facility | | $36,877.62 | $36,877.62 | $36,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,627.59 / $26,160.70 / $40,398.26
| Facility | | $22,627.59 | $26,160.70 | $40,398.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,382.10 / $67,968.28
| Facility | | $5,840.42 | $25,382.10 | $67,968.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,382.10 / $53,117.82
| Facility | | $5,840.42 | $25,382.10 | $53,117.82 |