- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $23,988.33 / $38,904.51
| Facility | | $15,848.93 | $23,988.33 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $25,118.86
| Facility | | $23,988.33 | $23,988.33 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $16,982.44 / $28,840.32
| Facility | | $8,709.64 | $16,982.44 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $26,302.68 / $46,773.51
| Facility | | $14,791.08 | $26,302.68 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60,255.96 / $60,255.96 / $60,255.96
| Facility | | $60,255.96 | $60,255.96 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $22,387.21 / $38,904.51
| Facility | | $9,120.11 | $22,387.21 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $21,877.62 / $50,118.72
| Facility | | $14,791.08 | $21,877.62 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $19,952.62 / $45,708.82
| Facility | | $6,456.54 | $19,952.62 | $45,708.82 |