- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $26,302.68 / $43,651.58
| Facility | | $12,589.25 | $26,302.68 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $24,547.09 / $64,565.42
| Facility | | $6,165.95 | $24,547.09 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $25,118.86 / $38,018.94
| Facility | | $14,791.08 | $25,118.86 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,307.81 / $36,307.81 / $36,307.81
| Facility | | $36,307.81 | $36,307.81 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $23,988.33 / $64,565.42
| Facility | | $6,165.95 | $23,988.33 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $24,547.09 / $64,565.42
| Facility | | $6,165.95 | $24,547.09 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $19,498.45 / $56,234.13
| Facility | | $6,165.95 | $19,498.45 | $56,234.13 |