- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,047.70 / $20,835.40 / $27,203.50
| Facility | | $10,047.70 | $20,835.40 | $27,203.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,781.21 / $50,950.47
| Facility | | $5,840.42 | $18,781.21 | $50,950.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,772.67 / $19,466.37 / $29,413.92
| Facility | | $11,772.67 | $19,466.37 | $29,413.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,644.25 / $27,644.25 / $27,644.25
| Facility | | $27,644.25 | $27,644.25 | $27,644.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,962.12 / $19,610.61 / $30,283.39
| Facility | | $16,962.12 | $19,610.61 | $30,283.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,781.21 / $50,950.47
| Facility | | $5,840.42 | $18,781.21 | $50,950.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,797.11 / $39,818.24
| Facility | | $5,840.42 | $14,797.11 | $39,818.24 |