- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,436.50 / $23,715.10 / $30,963.40
| Facility | | $11,436.50 | $23,715.10 | $30,963.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,656.77 / $57,992.59
| Facility | | $5,840.42 | $21,656.77 | $57,992.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,399.83 / $22,156.92 / $33,479.36
| Facility | | $13,399.83 | $22,156.92 | $33,479.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,465.10 / $31,465.10 / $31,465.10
| Facility | | $31,465.10 | $31,465.10 | $31,465.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,306.54 / $22,321.10 / $34,469.01
| Facility | | $19,306.54 | $22,321.10 | $34,469.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,656.77 / $57,992.59
| Facility | | $5,840.42 | $21,656.77 | $57,992.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,656.77 / $45,321.72
| Facility | | $5,840.42 | $21,656.77 | $45,321.72 |