- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,923.20 / $33,019.00 / $43,110.90
| Facility | | $15,923.20 | $33,019.00 | $43,110.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $30,153.08 / $80,744.06
| Facility | | $5,840.42 | $30,153.08 | $80,744.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,656.81 / $30,849.45 / $46,613.88
| Facility | | $18,656.81 | $30,849.45 | $46,613.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,809.39 / $43,809.39 / $43,809.39
| Facility | | $43,809.39 | $43,809.39 | $43,809.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,880.82 / $31,078.04 / $47,991.79
| Facility | | $26,880.82 | $31,078.04 | $47,991.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $30,153.08 / $80,744.06
| Facility | | $5,840.42 | $30,153.08 | $80,744.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $30,153.08 / $63,102.20
| Facility | | $5,840.42 | $30,153.08 | $63,102.20 |