- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,589.50 / $28,179.80 / $36,792.80
| Facility | | $13,589.50 | $28,179.80 | $36,792.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,733.97 / $68,910.55
| Facility | | $5,840.42 | $25,733.97 | $68,910.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,922.55 / $26,328.28 / $39,782.35
| Facility | | $15,922.55 | $26,328.28 | $39,782.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,388.87 / $37,388.87 / $37,388.87
| Facility | | $37,388.87 | $37,388.87 | $37,388.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,941.28 / $26,523.37 / $40,958.31
| Facility | | $22,941.28 | $26,523.37 | $40,958.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,733.97 / $68,910.55
| Facility | | $5,840.42 | $25,733.97 | $68,910.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,733.97 / $53,854.20
| Facility | | $5,840.42 | $25,733.97 | $53,854.20 |