- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $28,840.32 / $48,977.88
| Facility | | $14,125.38 | $28,840.32 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $26,915.35 / $70,794.58
| Facility | | $6,165.95 | $26,915.35 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $27,542.29 / $41,686.94
| Facility | | $16,218.10 | $27,542.29 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,738.03 / $40,738.03 / $40,738.03
| Facility | | $40,738.03 | $40,738.03 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $26,302.68 / $70,794.58
| Facility | | $6,165.95 | $26,302.68 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $26,915.35 / $70,794.58
| Facility | | $6,165.95 | $26,915.35 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $21,379.62 / $61,659.50
| Facility | | $6,165.95 | $21,379.62 | $61,659.50 |