- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $21,379.62 / $35,481.34
| Facility | | $10,232.93 | $21,379.62 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $19,498.45 / $51,286.14
| Facility | | $6,165.95 | $19,498.45 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $20,417.38 / $30,199.52
| Facility | | $12,022.64 | $20,417.38 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,512.09 / $29,512.09 / $29,512.09
| Facility | | $29,512.09 | $29,512.09 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $19,498.45 / $51,286.14
| Facility | | $6,165.95 | $19,498.45 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $19,498.45 / $51,286.14
| Facility | | $6,165.95 | $19,498.45 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $15,488.17 / $44,668.36
| Facility | | $6,165.95 | $15,488.17 | $44,668.36 |