- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,047.50 / $22,908.60 / $29,910.40
| Facility | | $11,047.50 | $22,908.60 | $29,910.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,920.25 / $56,020.34
| Facility | | $5,840.42 | $20,920.25 | $56,020.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,944.12 / $21,403.39 / $32,340.78
| Facility | | $12,944.12 | $21,403.39 | $32,340.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,395.01 / $30,395.01 / $30,395.01
| Facility | | $30,395.01 | $30,395.01 | $30,395.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,649.95 / $21,561.99 / $33,296.76
| Facility | | $18,649.95 | $21,561.99 | $33,296.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,920.25 / $56,020.34
| Facility | | $5,840.42 | $20,920.25 | $56,020.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,920.25 / $43,780.39
| Facility | | $5,840.42 | $20,920.25 | $43,780.39 |