- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,719.70 / $28,449.70 / $37,145.10
| Facility | | $13,719.70 | $28,449.70 | $37,145.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,644.87 / $69,570.50
| Facility | | $5,840.42 | $25,644.87 | $69,570.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,075.04 / $26,580.43 / $40,163.35
| Facility | | $16,075.04 | $26,580.43 | $40,163.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,746.94 / $37,746.94 / $37,746.94
| Facility | | $37,746.94 | $37,746.94 | $37,746.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,160.99 / $26,777.39 / $41,350.57
| Facility | | $23,160.99 | $26,777.39 | $41,350.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,644.87 / $69,570.50
| Facility | | $5,840.42 | $25,644.87 | $69,570.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,204.77 / $54,369.97
| Facility | | $5,840.42 | $20,204.77 | $54,369.97 |