- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,474.80 / $23,794.70 / $31,067.30
| Facility | | $11,474.80 | $23,794.70 | $31,067.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,448.77 / $58,187.14
| Facility | | $5,840.42 | $21,448.77 | $58,187.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,444.79 / $22,231.25 / $33,591.68
| Facility | | $13,444.79 | $22,231.25 | $33,591.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,570.66 / $31,570.66 / $31,570.66
| Facility | | $31,570.66 | $31,570.66 | $31,570.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,371.31 / $22,395.98 / $34,584.65
| Facility | | $19,371.31 | $22,395.98 | $34,584.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,448.77 / $58,187.14
| Facility | | $5,840.42 | $21,448.77 | $58,187.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,898.80 / $45,473.77
| Facility | | $5,840.42 | $16,898.80 | $45,473.77 |