- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,782.50 / $24,432.70 / $31,900.40
| Facility | | $11,782.50 | $24,432.70 | $31,900.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,312.09 / $59,747.40
| Facility | | $5,840.42 | $22,312.09 | $59,747.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,805.30 / $22,827.37 / $34,492.42
| Facility | | $13,805.30 | $22,827.37 | $34,492.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,417.21 / $32,417.21 / $32,417.21
| Facility | | $32,417.21 | $32,417.21 | $32,417.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,890.74 / $22,996.51 / $35,512.01
| Facility | | $19,890.74 | $22,996.51 | $35,512.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,312.09 / $59,747.40
| Facility | | $5,840.42 | $22,312.09 | $59,747.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,626.89 / $52,000.97
| Facility | | $5,840.42 | $22,626.89 | $52,000.97 |