- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,818.10 / $30,727.30 / $40,118.80
| Facility | | $14,818.10 | $30,727.30 | $40,118.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,697.92 / $75,140.12
| Facility | | $5,840.42 | $27,697.92 | $75,140.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,361.96 / $28,708.38 / $43,378.70
| Facility | | $17,361.96 | $28,708.38 | $43,378.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,768.85 / $40,768.85 / $40,768.85
| Facility | | $40,768.85 | $40,768.85 | $40,768.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,015.19 / $28,921.11 / $44,660.98
| Facility | | $25,015.19 | $28,921.11 | $44,660.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,697.92 / $75,140.12
| Facility | | $5,840.42 | $27,697.92 | $75,140.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,822.31 / $58,722.67
| Facility | | $5,840.42 | $21,822.31 | $58,722.67 |