- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $19,952.62 / $60,255.96
| Facility | | $16,982.44 | $19,952.62 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,657.95 / $42,657.95 / $45,708.82
| Facility | | $42,657.95 | $42,657.95 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $12,022.64 / $19,952.62
| Facility | | $12,022.64 | $12,022.64 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $16,595.87 / $26,302.68
| Facility | | $9,549.93 | $16,595.87 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,657.95 / $42,657.95 / $45,708.82
| Facility | | $42,657.95 | $42,657.95 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $5,754.40 / $5,754.40
| Facility | | $5,754.40 | $5,754.40 | $5,754.40 |