- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,992.79 / $20,721.50 / $27,054.80
| Facility | | $9,992.79 | $20,721.50 | $27,054.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,922.96 / $50,671.99
| Facility | | $5,840.42 | $18,922.96 | $50,671.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,708.33 / $19,359.97 / $29,253.15
| Facility | | $11,708.33 | $19,359.97 | $29,253.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,493.15 / $27,493.15 / $27,493.15
| Facility | | $27,493.15 | $27,493.15 | $27,493.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,869.41 / $19,503.43 / $30,117.87
| Facility | | $16,869.41 | $19,503.43 | $30,117.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,922.96 / $50,671.99
| Facility | | $5,840.42 | $18,922.96 | $50,671.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,922.96 / $39,600.61
| Facility | | $5,840.42 | $18,922.96 | $39,600.61 |