- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,436.70 / $21,641.90 / $28,256.50
| Facility | | $10,436.70 | $21,641.90 | $28,256.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,763.48 / $52,922.72
| Facility | | $5,840.42 | $19,763.48 | $52,922.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,228.38 / $20,219.90 / $30,552.51
| Facility | | $12,228.38 | $20,219.90 | $30,552.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,714.34 / $28,714.34 / $28,714.34
| Facility | | $28,714.34 | $28,714.34 | $28,714.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,618.71 / $20,369.73 / $31,455.64
| Facility | | $17,618.71 | $20,369.73 | $31,455.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,763.48 / $52,922.72
| Facility | | $5,840.42 | $19,763.48 | $52,922.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,763.48 / $41,359.57
| Facility | | $5,840.42 | $19,763.48 | $41,359.57 |