- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,901.60 / $30,900.50 / $40,344.90
| Facility | | $14,901.60 | $30,900.50 | $40,344.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,854.01 / $75,563.56
| Facility | | $5,840.42 | $27,854.01 | $75,563.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,788.27 / $28,664.16 / $43,623.16
| Facility | | $16,788.27 | $28,664.16 | $43,623.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,998.60 / $40,998.60 / $40,998.60
| Facility | | $40,998.60 | $40,998.60 | $40,998.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,156.16 / $29,084.09 / $44,912.66
| Facility | | $25,156.16 | $29,084.09 | $44,912.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,854.01 / $75,563.56
| Facility | | $5,840.42 | $27,854.01 | $75,563.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,945.28 / $59,053.59
| Facility | | $5,840.42 | $21,945.28 | $59,053.59 |