- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,358.70 / $42,216.70 / $55,119.90
| Facility | | $20,358.70 | $42,216.70 | $55,119.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $38,552.53 / $103,236.12
| Facility | | $5,840.42 | $38,552.53 | $103,236.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,853.85 / $39,442.87 / $59,598.64
| Facility | | $23,853.85 | $39,442.87 | $59,598.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,012.93 / $56,012.93 / $56,012.93
| Facility | | $56,012.93 | $56,012.93 | $56,012.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,368.74 / $39,735.12 / $61,360.38
| Facility | | $34,368.74 | $39,735.12 | $61,360.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $38,552.53 / $103,236.12
| Facility | | $5,840.42 | $38,552.53 | $103,236.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,981.99 / $80,679.94
| Facility | | $5,840.42 | $29,981.99 | $80,679.94 |