- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,564.50 / $21,907.10 / $28,602.80
| Facility | | $10,564.50 | $21,907.10 | $28,602.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,747.27 / $53,571.24
| Facility | | $5,840.42 | $19,747.27 | $53,571.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,378.23 / $20,467.66 / $30,926.90
| Facility | | $12,378.23 | $20,467.66 | $30,926.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,066.20 / $29,066.20 / $29,066.20
| Facility | | $29,066.20 | $29,066.20 | $29,066.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,834.61 / $20,619.34 / $31,841.10
| Facility | | $17,834.61 | $20,619.34 | $31,841.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,747.27 / $53,571.24
| Facility | | $5,840.42 | $19,747.27 | $53,571.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,558.24 / $41,866.40
| Facility | | $5,840.42 | $15,558.24 | $41,866.40 |