- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,068.20 / $27,098.80 / $35,381.30
| Facility | | $13,068.20 | $27,098.80 | $35,381.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,746.73 / $66,266.89
| Facility | | $5,840.42 | $24,746.73 | $66,266.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,311.70 / $25,318.23 / $38,256.15
| Facility | | $15,311.70 | $25,318.23 | $38,256.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,954.50 / $35,954.50 / $35,954.50
| Facility | | $35,954.50 | $35,954.50 | $35,954.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,061.17 / $25,505.84 / $39,387.01
| Facility | | $22,061.17 | $25,505.84 | $39,387.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,746.73 / $66,266.89
| Facility | | $5,840.42 | $24,746.73 | $66,266.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,746.73 / $51,788.16
| Facility | | $5,840.42 | $24,746.73 | $51,788.16 |