- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,321.90 / $25,551.20 / $33,360.69
| Facility | | $12,321.90 | $25,551.20 | $33,360.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,333.52 / $62,482.61
| Facility | | $5,840.42 | $23,333.52 | $62,482.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,437.30 / $23,872.39 / $36,071.47
| Facility | | $14,437.30 | $23,872.39 | $36,071.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,901.25 / $33,901.25 / $33,901.25
| Facility | | $33,901.25 | $33,901.25 | $33,901.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,801.33 / $24,049.29 / $37,137.74
| Facility | | $20,801.33 | $24,049.29 | $37,137.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,333.52 / $62,482.61
| Facility | | $5,840.42 | $23,333.52 | $62,482.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,333.52 / $48,830.71
| Facility | | $5,840.42 | $23,333.52 | $48,830.71 |