- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,282.80 / $25,470.10 / $33,254.80
| Facility | | $12,282.80 | $25,470.10 | $33,254.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,959.03 / $62,284.24
| Facility | | $5,840.42 | $22,959.03 | $62,284.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,391.47 / $23,796.60 / $35,956.94
| Facility | | $14,391.47 | $23,796.60 | $35,956.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,793.62 / $33,793.62 / $33,793.62
| Facility | | $33,793.62 | $33,793.62 | $33,793.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,735.29 / $23,972.93 / $37,019.83
| Facility | | $20,735.29 | $23,972.93 | $37,019.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,959.03 / $62,284.24
| Facility | | $5,840.42 | $22,959.03 | $62,284.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,088.68 / $48,675.69
| Facility | | $5,840.42 | $18,088.68 | $48,675.69 |