- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,854.70 / $24,582.50 / $32,095.90
| Facility | | $11,854.70 | $24,582.50 | $32,095.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,158.90 / $60,113.62
| Facility | | $5,840.42 | $22,158.90 | $60,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,889.92 / $22,967.29 / $34,703.83
| Facility | | $13,889.92 | $22,967.29 | $34,703.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,615.91 / $32,615.91 / $32,615.91
| Facility | | $32,615.91 | $32,615.91 | $32,615.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,012.66 / $23,137.47 / $35,729.69
| Facility | | $20,012.66 | $23,137.47 | $35,729.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,158.90 / $60,113.62
| Facility | | $5,840.42 | $22,158.90 | $60,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,458.29 / $46,979.33
| Facility | | $5,840.42 | $17,458.29 | $46,979.33 |