- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,660.50 / $26,253.20 / $34,277.30
| Facility | | $12,660.50 | $26,253.20 | $34,277.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,974.59 / $64,199.27
| Facility | | $5,840.42 | $23,974.59 | $64,199.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,833.96 / $24,528.27 / $37,062.51
| Facility | | $14,833.96 | $24,528.27 | $37,062.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,832.66 / $34,832.66 / $34,832.66
| Facility | | $34,832.66 | $34,832.66 | $34,832.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,372.83 / $24,710.02 / $38,158.07
| Facility | | $21,372.83 | $24,710.02 | $38,158.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,974.59 / $64,199.27
| Facility | | $5,840.42 | $23,974.59 | $64,199.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,974.59 / $50,172.30
| Facility | | $5,840.42 | $23,974.59 | $50,172.30 |