- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.20 / $28,622.90 / $37,371.19
| Facility | | $13,803.20 | $28,622.90 | $37,371.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,138.56 / $69,993.95
| Facility | | $5,840.42 | $26,138.56 | $69,993.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,172.88 / $26,742.21 / $40,407.80
| Facility | | $16,172.88 | $26,742.21 | $40,407.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,976.69 / $37,976.69 / $37,976.69
| Facility | | $37,976.69 | $37,976.69 | $37,976.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,301.96 / $26,940.37 / $41,602.26
| Facility | | $23,301.96 | $26,940.37 | $41,602.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,138.56 / $69,993.95
| Facility | | $5,840.42 | $26,138.56 | $69,993.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,138.56 / $54,700.89
| Facility | | $5,840.42 | $26,138.56 | $54,700.89 |