- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $29,512.09 / $48,977.88
| Facility | | $14,125.38 | $29,512.09 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $26,915.35 / $72,443.60
| Facility | | $6,165.95 | $26,915.35 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $27,542.29 / $41,686.94
| Facility | | $16,595.87 | $27,542.29 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,738.03 / $40,738.03 / $40,738.03
| Facility | | $40,738.03 | $40,738.03 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $26,915.35 / $72,443.60
| Facility | | $6,165.95 | $26,915.35 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $26,915.35 / $72,443.60
| Facility | | $6,165.95 | $26,915.35 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $23,442.29 / $63,095.73
| Facility | | $6,165.95 | $23,442.29 | $63,095.73 |