- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,084.90 / $25,059.80 / $32,719.20
| Facility | | $12,084.90 | $25,059.80 | $32,719.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,884.77 / $61,280.95
| Facility | | $5,840.42 | $22,884.77 | $61,280.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,159.64 / $23,413.28 / $35,377.75
| Facility | | $14,159.64 | $23,413.28 | $35,377.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,249.26 / $33,249.26 / $33,249.26
| Facility | | $33,249.26 | $33,249.26 | $33,249.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,401.28 / $23,586.77 / $36,423.51
| Facility | | $20,401.28 | $23,586.77 | $36,423.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,884.77 / $61,280.95
| Facility | | $5,840.42 | $22,884.77 | $61,280.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,884.77 / $47,891.60
| Facility | | $5,840.42 | $22,884.77 | $47,891.60 |