- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,698.09 / $34,625.80 / $45,208.80
| Facility | | $16,698.09 | $34,625.80 | $45,208.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $31,620.42 / $84,673.30
| Facility | | $5,840.42 | $31,620.42 | $84,673.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,564.71 / $32,350.67 / $48,882.25
| Facility | | $19,564.71 | $32,350.67 | $48,882.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,941.28 / $45,941.28 / $45,941.28
| Facility | | $45,941.28 | $45,941.28 | $45,941.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,188.92 / $32,590.39 / $50,327.21
| Facility | | $28,188.92 | $32,590.39 | $50,327.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $31,620.42 / $84,673.30
| Facility | | $5,840.42 | $31,620.42 | $84,673.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $31,620.42 / $66,172.92
| Facility | | $5,840.42 | $31,620.42 | $66,172.92 |