- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,503.80 / $28,002.00 / $36,560.60
| Facility | | $13,503.80 | $28,002.00 | $36,560.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,571.57 / $68,475.66
| Facility | | $5,840.42 | $25,571.57 | $68,475.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,822.06 / $26,162.13 / $39,531.29
| Facility | | $15,822.06 | $26,162.13 | $39,531.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,152.91 / $37,152.91 / $37,152.91
| Facility | | $37,152.91 | $37,152.91 | $37,152.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,796.50 / $26,355.99 / $40,699.83
| Facility | | $22,796.50 | $26,355.99 | $40,699.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,571.57 / $68,475.66
| Facility | | $5,840.42 | $25,571.57 | $68,475.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,571.57 / $53,514.34
| Facility | | $5,840.42 | $25,571.57 | $53,514.34 |