- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $26,302.68 / $44,668.36
| Facility | | $12,882.50 | $26,302.68 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $24,547.09 / $64,565.42
| Facility | | $6,165.95 | $24,547.09 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $25,118.86 / $38,018.94
| Facility | | $15,135.61 | $25,118.86 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,153.52 / $37,153.52 / $37,153.52
| Facility | | $37,153.52 | $37,153.52 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $23,988.33 / $64,565.42
| Facility | | $6,165.95 | $23,988.33 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $24,547.09 / $64,565.42
| Facility | | $6,165.95 | $24,547.09 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $20,417.38 / $56,234.13
| Facility | | $6,165.95 | $20,417.38 | $56,234.13 |