- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,274.90 / $21,306.50 / $27,818.60
| Facility | | $10,274.90 | $21,306.50 | $27,818.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,457.18 / $52,102.54
| Facility | | $5,840.42 | $19,457.18 | $52,102.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,038.87 / $19,906.54 / $30,079.01
| Facility | | $12,038.87 | $19,906.54 | $30,079.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,269.33 / $28,269.33 / $28,269.33
| Facility | | $28,269.33 | $28,269.33 | $28,269.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,345.66 / $20,054.04 / $30,968.15
| Facility | | $17,345.66 | $20,054.04 | $30,968.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,457.18 / $52,102.54
| Facility | | $5,840.42 | $19,457.18 | $52,102.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,457.18 / $40,718.60
| Facility | | $5,840.42 | $19,457.18 | $40,718.60 |