- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $39,810.72 / $56,234.13
| Facility | | $21,877.62 | $39,810.72 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $43,651.58 / $66,069.34
| Facility | | $22,908.68 | $43,651.58 | $66,069.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $36,307.81 / $51,286.14
| Facility | | $21,877.62 | $36,307.81 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,657.95 / $42,657.95 / $51,286.14
| Facility | | $42,657.95 | $42,657.95 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $39,810.72 / $50,118.72
| Facility | | $17,782.79 | $39,810.72 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,810.72 / $63,095.73 / $87,096.36
| Facility | | $39,810.72 | $63,095.73 | $87,096.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $37,153.52 / $56,234.13
| Facility | | $21,877.62 | $37,153.52 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $19,498.45 / $33,113.11
| Facility | | $16,218.10 | $19,498.45 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $29,512.09 / $50,118.72
| Facility | | $10,964.78 | $29,512.09 | $50,118.72 |