- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,048.30 / $31,204.70 / $40,742.10
| Facility | | $15,048.30 | $31,204.70 | $40,742.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,496.27 / $76,307.44
| Facility | | $5,840.42 | $28,496.27 | $76,307.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,631.68 / $29,154.37 / $44,052.61
| Facility | | $17,631.68 | $29,154.37 | $44,052.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,402.21 / $41,402.21 / $41,402.21
| Facility | | $41,402.21 | $41,402.21 | $41,402.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,403.81 / $29,370.40 / $45,354.80
| Facility | | $25,403.81 | $29,370.40 | $45,354.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,496.27 / $76,307.44
| Facility | | $5,840.42 | $28,496.27 | $76,307.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,496.27 / $59,634.94
| Facility | | $5,840.42 | $28,496.27 | $59,634.94 |