- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,453.60 / $25,824.20 / $33,717.19
| Facility | | $12,453.60 | $25,824.20 | $33,717.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,582.83 / $63,150.20
| Facility | | $5,840.42 | $23,582.83 | $63,150.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,591.56 / $24,127.46 / $36,456.87
| Facility | | $14,591.56 | $24,127.46 | $36,456.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,263.47 / $34,263.47 / $34,263.47
| Facility | | $34,263.47 | $34,263.47 | $34,263.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,023.58 / $24,306.24 / $37,534.54
| Facility | | $21,023.58 | $24,306.24 | $37,534.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,582.83 / $63,150.20
| Facility | | $5,840.42 | $23,582.83 | $63,150.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,582.83 / $49,352.44
| Facility | | $5,840.42 | $23,582.83 | $49,352.44 |