- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $28,183.83 / $46,773.51
| Facility | | $13,489.63 | $28,183.83 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $25,703.96 / $69,183.10
| Facility | | $6,165.95 | $25,703.96 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $26,915.35 / $39,810.72
| Facility | | $15,848.93 | $26,915.35 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $25,118.86 / $69,183.10
| Facility | | $6,165.95 | $25,118.86 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $25,703.96 / $69,183.10
| Facility | | $6,165.95 | $25,703.96 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $20,892.96 / $60,255.96
| Facility | | $6,165.95 | $20,892.96 | $60,255.96 |