- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,286.80 / $23,404.70 / $30,558.10
| Facility | | $11,286.80 | $23,404.70 | $30,558.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,373.27 / $57,233.44
| Facility | | $5,840.42 | $21,373.27 | $57,233.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,224.42 / $21,866.87 / $33,041.11
| Facility | | $13,224.42 | $21,866.87 | $33,041.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,053.21 / $31,053.21 / $31,053.21
| Facility | | $31,053.21 | $31,053.21 | $31,053.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,053.81 / $22,028.90 / $34,017.80
| Facility | | $19,053.81 | $22,028.90 | $34,017.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,373.27 / $57,233.44
| Facility | | $5,840.42 | $21,373.27 | $57,233.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,373.27 / $44,728.44
| Facility | | $5,840.42 | $21,373.27 | $44,728.44 |