- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,806.80 / $30,703.90 / $40,088.30
| Facility | | $14,806.80 | $30,703.90 | $40,088.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,676.83 / $75,082.89
| Facility | | $5,840.42 | $27,676.83 | $75,082.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,348.74 / $28,686.52 / $43,345.67
| Facility | | $17,348.74 | $28,686.52 | $43,345.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,737.80 / $40,737.80 / $40,737.80
| Facility | | $40,737.80 | $40,737.80 | $40,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,996.14 / $28,899.08 / $44,626.97
| Facility | | $24,996.14 | $28,899.08 | $44,626.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,676.83 / $75,082.89
| Facility | | $5,840.42 | $27,676.83 | $75,082.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,805.69 / $58,677.95
| Facility | | $5,840.42 | $21,805.69 | $58,677.95 |