- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $25,118.86 / $41,686.94
| Facility | | $12,022.64 | $25,118.86 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $22,387.21 / $60,255.96
| Facility | | $6,165.95 | $22,387.21 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $23,988.33 / $35,481.34
| Facility | | $14,125.38 | $23,988.33 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,673.69 / $34,673.69 / $34,673.69
| Facility | | $34,673.69 | $34,673.69 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $22,387.21 / $60,255.96
| Facility | | $6,165.95 | $22,387.21 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $22,387.21 / $60,255.96
| Facility | | $6,165.95 | $22,387.21 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $18,197.01 / $52,480.75
| Facility | | $6,165.95 | $18,197.01 | $52,480.75 |