- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,984.50 / $28,998.80 / $37,862.10
| Facility | | $13,984.50 | $28,998.80 | $37,862.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,481.89 / $70,913.32
| Facility | | $5,840.42 | $26,481.89 | $70,913.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,385.31 / $27,093.47 / $40,938.55
| Facility | | $16,385.31 | $27,093.47 | $40,938.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,475.51 / $38,475.51 / $38,475.51
| Facility | | $38,475.51 | $38,475.51 | $38,475.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,608.03 / $27,294.23 / $42,148.70
| Facility | | $23,608.03 | $27,294.23 | $42,148.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,481.89 / $70,913.32
| Facility | | $5,840.42 | $26,481.89 | $70,913.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,481.89 / $55,419.39
| Facility | | $5,840.42 | $26,481.89 | $55,419.39 |