- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,006.90 / $31,118.90 / $40,630.10
| Facility | | $15,006.90 | $31,118.90 | $40,630.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,050.88 / $76,097.63
| Facility | | $5,840.42 | $28,050.88 | $76,097.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,583.20 / $29,074.21 / $43,931.48
| Facility | | $17,583.20 | $29,074.21 | $43,931.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,288.37 / $41,288.37 / $41,288.37
| Facility | | $41,288.37 | $41,288.37 | $41,288.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,333.96 / $29,289.65 / $45,230.10
| Facility | | $25,333.96 | $29,289.65 | $45,230.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,050.88 / $76,097.63
| Facility | | $5,840.42 | $28,050.88 | $76,097.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,100.39 / $59,470.97
| Facility | | $5,840.42 | $22,100.39 | $59,470.97 |