- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $23,442.29 / $30,902.95
| Facility | | $14,454.40 | $23,442.29 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $15,488.17 / $15,488.17
| Facility | | $15,488.17 | $15,488.17 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $32,359.37 / $39,810.72
| Facility | | $22,387.21 | $32,359.37 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $28,183.83
| Facility | | $28,183.83 | $28,183.83 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $21,877.62 / $28,840.32
| Facility | | $14,791.08 | $21,877.62 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $28,183.83
| Facility | | $28,183.83 | $28,183.83 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $20,417.38 / $32,359.37
| Facility | | $12,882.50 | $20,417.38 | $32,359.37 |