- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,569.20 / $28,137.70 / $36,737.80
| Facility | | $13,569.20 | $28,137.70 | $36,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,363.63 / $68,807.55
| Facility | | $5,840.42 | $25,363.63 | $68,807.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,898.75 / $26,288.93 / $39,722.89
| Facility | | $15,898.75 | $26,288.93 | $39,722.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,332.98 / $37,332.98 / $37,332.98
| Facility | | $37,332.98 | $37,332.98 | $37,332.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,906.99 / $26,483.73 / $40,897.08
| Facility | | $22,906.99 | $26,483.73 | $40,897.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,363.63 / $68,807.55
| Facility | | $5,840.42 | $25,363.63 | $68,807.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,983.18 / $53,773.71
| Facility | | $5,840.42 | $19,983.18 | $53,773.71 |