- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $21,877.62 / $36,307.81
| Facility | | $10,471.29 | $21,877.62 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $20,417.38 / $53,703.18
| Facility | | $6,165.95 | $20,417.38 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $20,892.96 / $30,902.95
| Facility | | $12,302.69 | $20,892.96 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,199.52 / $30,199.52 / $30,199.52
| Facility | | $30,199.52 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $19,952.62 / $53,703.18
| Facility | | $6,165.95 | $19,952.62 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $20,417.38 / $53,703.18
| Facility | | $6,165.95 | $20,417.38 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,218.10 / $46,773.51
| Facility | | $6,165.95 | $16,218.10 | $46,773.51 |