- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,512.60 / $30,094.00 / $39,291.90
| Facility | | $14,512.60 | $30,094.00 | $39,291.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,481.96 / $73,591.31
| Facility | | $5,840.42 | $27,481.96 | $73,591.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,004.09 / $28,116.63 / $42,484.57
| Facility | | $17,004.09 | $28,116.63 | $42,484.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,928.51 / $39,928.51 / $39,928.51
| Facility | | $39,928.51 | $39,928.51 | $39,928.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,499.57 / $28,324.98 / $43,740.41
| Facility | | $24,499.57 | $28,324.98 | $43,740.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,481.96 / $73,591.31
| Facility | | $5,840.42 | $27,481.96 | $73,591.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,481.96 / $57,512.26
| Facility | | $5,840.42 | $27,481.96 | $57,512.26 |