- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,059.10 / $43,669.10 / $57,016.10
| Facility | | $21,059.10 | $43,669.10 | $57,016.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $39,878.83 / $106,787.70
| Facility | | $5,840.42 | $39,878.83 | $106,787.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,674.49 / $40,799.80 / $61,648.98
| Facility | | $24,674.49 | $40,799.80 | $61,648.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57,939.91 / $57,939.91 / $57,939.91
| Facility | | $57,939.91 | $57,939.91 | $57,939.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,551.11 / $41,102.12 / $63,471.33
| Facility | | $35,551.11 | $41,102.12 | $63,471.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $39,878.83 / $106,787.70
| Facility | | $5,840.42 | $39,878.83 | $106,787.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $39,878.83 / $83,455.53
| Facility | | $5,840.42 | $39,878.83 | $83,455.53 |