- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $34,673.69 / $53,703.18
| Facility | | $25,703.96 | $34,673.69 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $6,918.31 / $6,918.31
| Facility | | $6,918.31 | $6,918.31 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $29,512.09 / $53,703.18
| Facility | | $10,715.19 | $29,512.09 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $25,703.96 / $151,356.12
| Facility | | $25,703.96 | $25,703.96 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $32,359.37 / $54,954.09
| Facility | | $10,715.19 | $32,359.37 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $34,673.69 / $58,884.37
| Facility | | $16,982.44 | $34,673.69 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $30,902.95 / $51,286.14
| Facility | | $17,782.79 | $30,902.95 | $51,286.14 |