- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,944.30 / $24,768.10 / $32,338.30
| Facility | | $11,944.30 | $24,768.10 | $32,338.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,618.37 / $60,567.58
| Facility | | $5,840.42 | $22,618.37 | $60,567.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,994.81 / $23,140.73 / $34,965.92
| Facility | | $13,994.81 | $23,140.73 | $34,965.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,862.21 / $32,862.21 / $32,862.21
| Facility | | $32,862.21 | $32,862.21 | $32,862.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,163.79 / $23,312.20 / $35,999.51
| Facility | | $20,163.79 | $23,312.20 | $35,999.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,618.37 / $60,567.58
| Facility | | $5,840.42 | $22,618.37 | $60,567.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,618.37 / $47,334.10
| Facility | | $5,840.42 | $22,618.37 | $47,334.10 |