- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,979.80 / $22,768.20 / $29,727.10
| Facility | | $10,979.80 | $22,768.20 | $29,727.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,792.04 / $55,677.01
| Facility | | $5,840.42 | $20,792.04 | $55,677.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,864.79 / $21,272.21 / $32,142.57
| Facility | | $12,864.79 | $21,272.21 | $32,142.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,208.73 / $30,208.73 / $30,208.73
| Facility | | $30,208.73 | $30,208.73 | $30,208.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,535.65 / $21,429.84 / $33,092.69
| Facility | | $18,535.65 | $21,429.84 | $33,092.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,792.04 / $55,677.01
| Facility | | $5,840.42 | $20,792.04 | $55,677.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,792.04 / $43,512.07
| Facility | | $5,840.42 | $20,792.04 | $43,512.07 |