- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $28,183.83 / $41,686.94
| Facility | | $20,892.96 | $28,183.83 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $32,359.37
| Facility | | $21,379.62 | $21,379.62 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $23,988.33 / $41,686.94
| Facility | | $10,232.93 | $23,988.33 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $28,183.83 / $39,810.72
| Facility | | $21,379.62 | $28,183.83 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $26,915.35 / $42,657.95
| Facility | | $12,882.50 | $26,915.35 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $23,988.33 / $36,307.81
| Facility | | $15,135.61 | $23,988.33 | $36,307.81 |