- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,446.10 / $25,808.60 / $33,696.80
| Facility | | $12,446.10 | $25,808.60 | $33,696.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,264.17 / $63,112.05
| Facility | | $5,840.42 | $23,264.17 | $63,112.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,582.74 / $24,112.88 / $36,434.85
| Facility | | $14,582.74 | $24,112.88 | $36,434.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,242.76 / $34,242.76 / $34,242.76
| Facility | | $34,242.76 | $34,242.76 | $34,242.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,010.88 / $24,291.56 / $37,511.87
| Facility | | $21,010.88 | $24,291.56 | $37,511.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,264.17 / $63,112.05
| Facility | | $5,840.42 | $23,264.17 | $63,112.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,329.09 / $49,322.63
| Facility | | $5,840.42 | $18,329.09 | $49,322.63 |