- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,487.20 / $27,967.70 / $36,515.80
| Facility | | $13,487.20 | $27,967.70 | $36,515.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,540.23 / $68,391.73
| Facility | | $5,840.42 | $25,540.23 | $68,391.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,802.67 / $26,130.06 / $39,482.83
| Facility | | $15,802.67 | $26,130.06 | $39,482.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,107.37 / $37,107.37 / $37,107.37
| Facility | | $37,107.37 | $37,107.37 | $37,107.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,768.56 / $26,323.68 / $40,649.94
| Facility | | $22,768.56 | $26,323.68 | $40,649.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,540.23 / $68,391.73
| Facility | | $5,840.42 | $25,540.23 | $68,391.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,540.23 / $53,448.75
| Facility | | $5,840.42 | $25,540.23 | $53,448.75 |