- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,710.10 / $26,356.20 / $34,411.69
| Facility | | $12,710.10 | $26,356.20 | $34,411.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,068.62 / $64,451.05
| Facility | | $5,840.42 | $24,068.62 | $64,451.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,892.13 / $24,624.46 / $37,207.86
| Facility | | $14,892.13 | $24,624.46 | $37,207.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,969.26 / $34,969.26 / $34,969.26
| Facility | | $34,969.26 | $34,969.26 | $34,969.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,456.65 / $24,806.93 / $38,307.72
| Facility | | $21,456.65 | $24,806.93 | $38,307.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,068.62 / $64,451.05
| Facility | | $5,840.42 | $24,068.62 | $64,451.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,068.62 / $50,369.06
| Facility | | $5,840.42 | $24,068.62 | $50,369.06 |