- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,698.50 / $22,184.80 / $28,965.30
| Facility | | $10,698.50 | $22,184.80 | $28,965.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,997.57 / $54,250.27
| Facility | | $5,840.42 | $19,997.57 | $54,250.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,535.13 / $20,727.11 / $31,318.91
| Facility | | $12,535.13 | $20,727.11 | $31,318.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,434.63 / $29,434.63 / $29,434.63
| Facility | | $29,434.63 | $29,434.63 | $29,434.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,060.66 / $20,880.68 / $32,244.70
| Facility | | $18,060.66 | $20,880.68 | $32,244.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,997.57 / $54,250.27
| Facility | | $5,840.42 | $19,997.57 | $54,250.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,755.45 / $42,397.07
| Facility | | $5,840.42 | $15,755.45 | $42,397.07 |