- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,557.10 / $29,685.30 / $50,120.70
| Facility | | $13,557.10 | $29,685.30 | $50,120.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,022.52 / $46,035.28 / $59,693.59
| Facility | | $31,022.52 | $46,035.28 | $59,693.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,593.05 / $42,316.91 / $62,118.84
| Facility | | $29,593.05 | $42,316.91 | $62,118.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,776.27 / $41,843.62 / $87,747.40
| Facility | | $21,776.27 | $41,843.62 | $87,747.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,740.50 / $13,740.50 / $13,740.50
| Facility | | $13,740.50 | $13,740.50 | $13,740.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,593.05 / $46,072.97 / $62,461.31
| Facility | | $29,593.05 | $46,072.97 | $62,461.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,573.52 / $37,965.78 / $58,578.35
| Facility | | $8,573.52 | $37,965.78 | $58,578.35 |