- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $26,915.35 / $38,904.51
| Facility | | $14,791.08 | $26,915.35 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $30,199.52 / $44,668.36
| Facility | | $19,952.62 | $30,199.52 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $25,118.86 / $39,810.72
| Facility | | $14,125.38 | $25,118.86 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $28,840.32 / $34,673.69
| Facility | | $28,840.32 | $28,840.32 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $26,915.35 / $33,113.11
| Facility | | $14,454.40 | $26,915.35 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $28,840.32 / $38,904.51
| Facility | | $17,782.79 | $28,840.32 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $26,302.68 / $38,018.94
| Facility | | $14,791.08 | $26,302.68 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $13,489.63 / $18,620.87
| Facility | | $11,220.18 | $13,489.63 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $19,952.62 / $33,884.42
| Facility | | $5,370.32 | $19,952.62 | $33,884.42 |