- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,392.80 / $23,624.60 / $30,845.30
| Facility | | $11,392.80 | $23,624.60 | $30,845.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,574.14 / $57,771.33
| Facility | | $5,840.42 | $21,574.14 | $57,771.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,348.71 / $22,072.38 / $33,351.62
| Facility | | $13,348.71 | $22,072.38 | $33,351.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,345.05 / $31,345.05 / $31,345.05
| Facility | | $31,345.05 | $31,345.05 | $31,345.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,232.88 / $22,235.94 / $34,337.51
| Facility | | $19,232.88 | $22,235.94 | $34,337.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,574.14 / $57,771.33
| Facility | | $5,840.42 | $21,574.14 | $57,771.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,574.14 / $45,148.81
| Facility | | $5,840.42 | $21,574.14 | $45,148.81 |