- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,491.90 / $25,903.80 / $33,821.10
| Facility | | $12,491.90 | $25,903.80 | $33,821.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,655.48 / $63,344.75
| Facility | | $5,840.42 | $23,655.48 | $63,344.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,636.51 / $24,201.79 / $36,569.19
| Facility | | $14,636.51 | $24,201.79 | $36,569.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,369.03 / $34,369.03 / $34,369.03
| Facility | | $34,369.03 | $34,369.03 | $34,369.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,088.35 / $24,381.12 / $37,650.18
| Facility | | $21,088.35 | $24,381.12 | $37,650.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,655.48 / $63,344.75
| Facility | | $5,840.42 | $23,655.48 | $63,344.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,989.24 / $55,131.92
| Facility | | $5,840.42 | $23,989.24 | $55,131.92 |