- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,613.40 / $30,303.00 / $39,564.80
| Facility | | $14,613.40 | $30,303.00 | $39,564.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,315.44 / $74,102.49
| Facility | | $5,840.42 | $27,315.44 | $74,102.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,122.21 / $28,311.94 / $42,779.68
| Facility | | $17,122.21 | $28,311.94 | $42,779.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,205.87 / $40,205.87 / $40,205.87
| Facility | | $40,205.87 | $40,205.87 | $40,205.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,669.75 / $28,521.73 / $44,044.25
| Facility | | $24,669.75 | $28,521.73 | $44,044.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,315.44 / $74,102.49
| Facility | | $5,840.42 | $27,315.44 | $74,102.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,520.96 / $57,911.75
| Facility | | $5,840.42 | $21,520.96 | $57,911.75 |