- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,066.30 / $22,947.60 / $29,961.30
| Facility | | $11,066.30 | $22,947.60 | $29,961.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,955.87 / $56,115.71
| Facility | | $5,840.42 | $20,955.87 | $56,115.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,966.16 / $21,439.83 / $32,395.83
| Facility | | $12,966.16 | $21,439.83 | $32,395.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,446.76 / $30,446.76 / $30,446.76
| Facility | | $30,446.76 | $30,446.76 | $30,446.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,681.70 / $21,598.69 / $33,353.44
| Facility | | $18,681.70 | $21,598.69 | $33,353.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,955.87 / $56,115.71
| Facility | | $5,840.42 | $20,955.87 | $56,115.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,955.87 / $43,854.92
| Facility | | $5,840.42 | $20,955.87 | $43,854.92 |