- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,379.80 / $33,965.90 / $44,347.20
| Facility | | $16,379.80 | $33,965.90 | $44,347.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $31,017.82 / $83,059.64
| Facility | | $5,840.42 | $31,017.82 | $83,059.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,191.84 / $31,734.15 / $47,950.68
| Facility | | $19,191.84 | $31,734.15 | $47,950.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,065.76 / $45,065.76 / $45,065.76
| Facility | | $45,065.76 | $45,065.76 | $45,065.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,651.71 / $31,969.30 / $49,368.10
| Facility | | $27,651.71 | $31,969.30 | $49,368.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $31,017.82 / $83,059.64
| Facility | | $5,840.42 | $31,017.82 | $83,059.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $31,017.82 / $64,911.84
| Facility | | $5,840.42 | $31,017.82 | $64,911.84 |