- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,501.50 / $27,997.30 / $36,554.40
| Facility | | $13,501.50 | $27,997.30 | $36,554.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,237.07 / $68,464.22
| Facility | | $5,840.42 | $25,237.07 | $68,464.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,819.42 / $26,157.75 / $39,524.68
| Facility | | $15,819.42 | $26,157.75 | $39,524.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,146.69 / $37,146.69 / $37,146.69
| Facility | | $37,146.69 | $37,146.69 | $37,146.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,792.69 / $26,351.58 / $40,693.03
| Facility | | $22,792.69 | $26,351.58 | $40,693.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,237.07 / $68,464.22
| Facility | | $5,840.42 | $25,237.07 | $68,464.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,883.48 / $53,505.39
| Facility | | $5,840.42 | $19,883.48 | $53,505.39 |