- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,712.40 / $26,360.90 / $34,417.80
| Facility | | $12,712.40 | $26,360.90 | $34,417.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,072.89 / $64,462.49
| Facility | | $5,840.42 | $24,072.89 | $64,462.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,894.78 / $24,628.84 / $37,214.47
| Facility | | $14,894.78 | $24,628.84 | $37,214.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,975.48 / $34,975.48 / $34,975.48
| Facility | | $34,975.48 | $34,975.48 | $34,975.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,460.46 / $24,811.33 / $38,314.53
| Facility | | $21,460.46 | $24,811.33 | $38,314.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,072.89 / $64,462.49
| Facility | | $5,840.42 | $24,072.89 | $64,462.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,412.54 / $56,104.74
| Facility | | $5,840.42 | $24,412.54 | $56,104.74 |