- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $31,622.78 / $52,480.75
| Facility | | $15,135.61 | $31,622.78 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $28,840.32 / $77,624.71
| Facility | | $6,165.95 | $28,840.32 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $30,199.52 / $44,668.36
| Facility | | $17,782.79 | $30,199.52 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $43,651.58
| Facility | | $43,651.58 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $28,840.32 / $77,624.71
| Facility | | $6,165.95 | $28,840.32 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $28,840.32 / $77,624.71
| Facility | | $6,165.95 | $28,840.32 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $23,442.29 / $67,608.30
| Facility | | $6,165.95 | $23,442.29 | $67,608.30 |