- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $33,113.11 / $53,703.18
| Facility | | $21,877.62 | $33,113.11 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $24,547.09 / $42,657.95
| Facility | | $12,589.25 | $24,547.09 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $38,018.94 / $66,069.34
| Facility | | $20,892.96 | $38,018.94 | $66,069.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83,176.38 / $83,176.38 / $83,176.38
| Facility | | $83,176.38 | $83,176.38 | $83,176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $31,622.78 / $53,703.18
| Facility | | $12,589.25 | $31,622.78 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $30,199.52 / $70,794.58
| Facility | | $20,417.38 | $30,199.52 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $28,183.83 / $63,095.73
| Facility | | $7,079.46 | $28,183.83 | $63,095.73 |