- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $35,481.34 / $42,657.95
| Facility | | $28,840.32 | $35,481.34 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $31,622.78 / $51,286.14
| Facility | | $30,902.95 | $31,622.78 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $35,481.34 / $56,234.13
| Facility | | $27,542.29 | $35,481.34 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $42,657.95 / $42,657.95
| Facility | | $21,379.62 | $42,657.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $39,810.72 / $60,255.96
| Facility | | $28,840.32 | $39,810.72 | $60,255.96 |