- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,151.50 / $21,050.60 / $27,484.60
| Facility | | $10,151.50 | $21,050.60 | $27,484.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,223.55 / $51,476.91
| Facility | | $5,840.42 | $19,223.55 | $51,476.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,894.31 / $19,667.50 / $29,717.84
| Facility | | $11,894.31 | $19,667.50 | $29,717.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,929.88 / $27,929.88 / $27,929.88
| Facility | | $27,929.88 | $27,929.88 | $27,929.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,137.38 / $19,813.24 / $30,596.30
| Facility | | $17,137.38 | $19,813.24 | $30,596.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,223.55 / $51,476.91
| Facility | | $5,840.42 | $19,223.55 | $51,476.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,223.55 / $40,229.66
| Facility | | $5,840.42 | $19,223.55 | $40,229.66 |