- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,856.40 / $22,512.40 / $29,393.10
| Facility | | $10,856.40 | $22,512.40 | $29,393.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,558.40 / $55,051.38
| Facility | | $5,840.42 | $20,558.40 | $55,051.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,720.23 / $21,033.18 / $31,781.39
| Facility | | $12,720.23 | $21,033.18 | $31,781.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,869.28 / $29,869.28 / $29,869.28
| Facility | | $29,869.28 | $29,869.28 | $29,869.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,327.37 / $21,189.04 / $32,720.85
| Facility | | $18,327.37 | $21,189.04 | $32,720.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,558.40 / $55,051.38
| Facility | | $5,840.42 | $20,558.40 | $55,051.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,558.40 / $43,023.14
| Facility | | $5,840.42 | $20,558.40 | $43,023.14 |