- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,773.30 / $26,487.20 / $34,582.80
| Facility | | $12,773.30 | $26,487.20 | $34,582.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,188.28 / $64,771.49
| Facility | | $5,840.42 | $24,188.28 | $64,771.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,966.17 / $24,746.89 / $37,392.85
| Facility | | $14,966.17 | $24,746.89 | $37,392.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,143.12 / $35,143.12 / $35,143.12
| Facility | | $35,143.12 | $35,143.12 | $35,143.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,563.33 / $24,930.27 / $38,498.18
| Facility | | $21,563.33 | $24,930.27 | $38,498.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,188.28 / $64,771.49
| Facility | | $5,840.42 | $24,188.28 | $64,771.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,188.28 / $50,619.49
| Facility | | $5,840.42 | $24,188.28 | $50,619.49 |