- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,031.50 / $24,949.10 / $32,574.50
| Facility | | $12,031.50 | $24,949.10 | $32,574.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,489.36 / $61,010.10
| Facility | | $5,840.42 | $22,489.36 | $61,010.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,097.06 / $23,309.80 / $35,221.37
| Facility | | $14,097.06 | $23,309.80 | $35,221.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,102.31 / $33,102.31 / $33,102.31
| Facility | | $33,102.31 | $33,102.31 | $33,102.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,311.11 / $23,482.52 / $36,262.53
| Facility | | $20,311.11 | $23,482.52 | $36,262.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,489.36 / $61,010.10
| Facility | | $5,840.42 | $22,489.36 | $61,010.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,718.64 / $47,679.93
| Facility | | $5,840.42 | $17,718.64 | $47,679.93 |