- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,062.00 / $29,159.50 / $38,071.90
| Facility | | $14,062.00 | $29,159.50 | $38,071.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,628.62 / $71,306.24
| Facility | | $5,840.42 | $26,628.62 | $71,306.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,476.09 / $27,243.59 / $41,165.39
| Facility | | $16,476.09 | $27,243.59 | $41,165.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,688.69 / $38,688.69 / $38,688.69
| Facility | | $38,688.69 | $38,688.69 | $38,688.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,738.84 / $27,445.46 / $42,382.24
| Facility | | $23,738.84 | $27,445.46 | $42,382.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,628.62 / $71,306.24
| Facility | | $5,840.42 | $26,628.62 | $71,306.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,628.62 / $55,726.46
| Facility | | $5,840.42 | $26,628.62 | $55,726.46 |