- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,975.90 / $24,833.60 / $32,423.80
| Facility | | $11,975.90 | $24,833.60 | $32,423.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,385.30 / $60,727.80
| Facility | | $5,840.42 | $22,385.30 | $60,727.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,031.83 / $23,201.94 / $35,058.41
| Facility | | $14,031.83 | $23,201.94 | $35,058.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,949.15 / $32,949.15 / $32,949.15
| Facility | | $32,949.15 | $32,949.15 | $32,949.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,217.13 / $23,373.87 / $36,094.74
| Facility | | $20,217.13 | $23,373.87 | $36,094.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,385.30 / $60,727.80
| Facility | | $5,840.42 | $22,385.30 | $60,727.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,636.66 / $47,459.31
| Facility | | $5,840.42 | $17,636.66 | $47,459.31 |